Evolving Approaches and Resources for Clinical Practice in the Management of HIV Infection in the HAART Era

Physicians treating HIV infection concentrate not only on the viral management but they also have to take into account the potential age and lifestyle-related conditions likely to influence long-term morbidity, correlated with patients’ survival. Hypertension, diabetes, cardiovascular, bone, kidney and liver disease, better than opportunistic infection, depict the changing spectrum of HIV disease in the HAART era. These conditions, the so called non infectious co-morbidities, are age-related diseases affecting the general population. However, their prevalence in HIV-infected individuals is higher, with earlier onset, probably as a result of the complex inter-relationship between HIV infection, co-infection and antiretroviral therapy. Regular screening for non infectious co-morbidities helps identify those asymptomatic HIV-infected individuals who are most at risk of developing comorbidities; this means that appropriate intervention, either by lifestyle changes to reduce modifiable risk factors or by the use of pharmacological management, can be initiated.