Premature Age-Related Comorbidities Among HIV-Infected Persons Compared With the General Population

Guaraldi, Giovanni; Orlando, Gabriella; Zona, Stefano; Menozzi, Marianna; Carli, Federica; Garlassi, Elisa; Berti, Alessandra Paim; Rossi, Elisa; Roverato, Alberto; Palella, Frank J.

doi:10.1093/cid/cir627

Cited by 1,137 publications

(986 citation statements)

References 27 publications

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“…26,27 Studies also confirm that polypathology (more than comorbidities) is more common in older, male HIV patients. 15,28 The prevalence of comorbidity, particularly polypathology, in older patients confirms the need to treat HIV similarly to other chronic diseases: for example, considering routine monitoring in primary care in partnership with secondary care and exploring the use of a range of services including nursing, preventive and rehabilitation services, as well as home health and nursing homes. 29,30 There is also a clear need to tailor care provision for people with HIV to reduce mortality and morbidity risks by preventing comorbidities; through encouragement of lifestyle changes, screening, 29 education about comorbidity risks 15 and widening knowledge about self-management in those with multiple long-term conditions.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

Lorenc

Ananthavarathan²,

Lorigan

et al. 2014

London Journal of Primary Care

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Section: Discussionmentioning

confidence: 99%

The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

Lorenc

Ananthavarathan²,

Lorigan

et al. 2014

London Journal of Primary Care

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“…8 Baik karena proses penuaan yang dipercepat ataupun faktor gaya hidup, tingkat komorbid non-HIV yang terkait dengan HIV meningkat seiring dengan bertambahnya usia, setara jika dibandingkan dengan populasi yang tidak terinfeksi HIV yang berusia 10-15 tahun lebih tua. [8][9][10][11][12] teori dapat mempercepat proses penuaan. 15,16 Selain itu, pada pasien HIV yang belum mendapat terapi ARV, serta pada pasien HIVusia lanjut dijumpai hal-hal sebagai berikut: 1) ekspresi limfosit T dan cyclin-dependent kinase inhibitor 2A (CDKN2A); 2) akumulasi sel T CD28-CD8+; 3) berkurangnya generasi sel T naif; 4) sel T repertoire yang rendah; 5) rasio CD4+/CD8+ yang rendah; 6) ekspansi efektor sel T CD28; 7) kurangnya respons terhadap vaksin; dan 8) berlangsungnya aktivasi sistem imun yang terjadi terus menerus.…”

Section: Pengaruh Hiv Terhadap Proses Penuaanunclassified

HIV pada Geriatri HIV in Geriatrics

Ainun¹,

Yunihastuti²,

Roosheroe³

2017

JPDI

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ABSTRAKJumlah pasien HIV yang berusia lanjut semakin bertambah dikarenakan angka kesintasan pasien yang meningkat dan infeksi HIV pada pasien usia lanjut. Populasi pasien tersebut membutuhkan penatalaksaan tersendiri dikarenakan terdapat sejumlah komorbid baik yang berhubungan dengan HIV maupun tidak, polifarmasi, penurunan kapasitas fungsional dan isu sosial. PENDAHULUANJumlah pasien HIV berusia tua meningkat dari tahun ke tahun. Hal ini selain disebabkan oleh angka kejadian yang meningkat, juga disebabkan oleh terapi antiretroviral yang efektif sehingga angka harapan hidup bertambah. Sejak highly active anti-retroviral therapy (HAART) diperkenalkan pada tahun 1996 dan dimulai terapi anti retroviral kombinasi, pasien HIV yang terdiagnosis awal dan mendapat terapi antiretroviral dapat hidup seperti orang normal pada umumnya. 1 Pada penelitian yang dilakukan oleh Greene, dkk. 2 ditemukan rentang waktu terpanjang dari pasien terdiagnosis HIV hingga saat penelitian dilakukan mencapai 21 tahun. 2 Terapi antiretroviral menurunkan efek HIV dan peradangan kronik, namun tidak halnya dengan fungsi imunologis normal. Angka kesintasan pada pasien HIVusia lanjut yang mendapat terapi antiretroviral 30% lebih rendah dibanding populasi muda. Selain itu, kematian lebih cepat terjadi dalam empat tahun pertama semenjak terapi antiretroviral dimulai. 3 Belum diketahui pasti penyebabnya, namun diperkirakan perhatian yang kurang terhadap kepatuhan berobat, interaksi obat dan toksisitas, serta komorbid multipel memiliki pengaruh. Dengan demikian, dibutuhkan pendekatan tersendiri dalam menangani pasien HIVusia lanjut.

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“…Tyrosine kinase receptors, most of the growth factor receptors, such as epidermal growth factor receptor, vascular endothelial growth factor receptor, and receptor for plateletderived growth factor, protein tyrosine phosphatases, and serine/ threonine kinases are targets of ROS. Extracellular signal-regulated kinases, JNK, and p38, which are the members of mitogen-activated protein kinase family and are involved in several cellular processes including proliferation, differentiation, and apoptosis, also can be regulated by oxidants [35].…”

Section: Ros Generation Biological Functions and Oxidative Stress Inmentioning

confidence: 99%

Altered Redox Regulation as Cofactor in Comorbidities and Accelerated Aging in HIV Infection Evolution and Antiretroviral Treatment

Valle¹

2014

Epidemiol

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Metabolic issues persist in HIV patients who are otherwise stable with and without antiretroviral treatment. Metabolic alterations are associated to chronic inflammation, severe mitochondrial toxicity and oxidative stress as critical factors influencing HIV disease outcomes even during antiretroviral treatment. These aspects could also be involved in comorbidities and premature aging. Both factors should be managed during therapy and they should be focus of intense ongoing investigation.The aim of this mini-review is to describe essential mechanisms of in vivo reactive oxygen species generation, antioxidants pathways, and oxidative stress involved in HIV disease. Potential impact on reactive oxygen species, oxidative damage, cellular function, and how these responses change could mediate aging in pathophysiological situations are discussed. Accrual experimental and clinical reports analyses allow us a better understanding of various inter-related contributing factors. In addition, oxidative stress as an often-overlooked link between HIVinfection and the progression of aids, during antiretroviral treatment, is analyzed. Potential long-term consequences of antioxidant treatment require on-going investigation in order to obtain important clinical issues that have recently been reported. Currently, the most practical advice is to start antiretroviral therapy early and to manage traditional risk factors of non-aids-related conditions.

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Premature Age-Related Comorbidities Among HIV-Infected Persons Compared With the General Population

Cited by 1,137 publications

References 27 publications

The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

The prevalence of comorbidities among people living with HIV in Brent: a diverse London Borough

HIV pada Geriatri HIV in Geriatrics

Altered Redox Regulation as Cofactor in Comorbidities and Accelerated Aging in HIV Infection Evolution and Antiretroviral Treatment

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