Bogner J R
Sektion Klinische Infektiologie, Medizinische Klinik und Poliklinik IV, Campus Innenstadt, Klinikum der Universität München, Pettenkoferstr. 8a, 80336, München, Deutschland.
Internist (Berl). 2012 Oct;53(10):1169-78. doi: 10.1007/s00108-011-2972-7.
While HIV therapy is highly efficient comorbidities come into the focus of HIV long-term treatment and prognosis. The pathogenesis of many comorbid diseases is determined not only by the biological effects of the HIV infection itself but also by lifestyle and long-term adverse reactions of antiviral treatment. The HIV specialist should nowadays be an all-round internist or needs a good infrastructure of cooperation. Cardiovascular risk factors in HIV infection include serum lipids, especially high LDL levels under antiviral treatment. They can be managed either by a switch of HIV therapy of by the addition of lipid-lowering agents. However, smoking habits and normalization of high blood pressure are also of importance. Further important comorbidities present in patients are viral hepatitis B or C, nephropathy (HIV or secondary) and changes of bone turnover resulting in lower bone mass and stability. Other aspects include vaccination status and prevention also for non-HIV associated carcinomas.
虽然HIV治疗非常有效，但合并症已成为HIV长期治疗和预后的关注焦点。许多合并症的发病机制不仅取决于HIV感染本身的生物学效应，还取决于生活方式和抗病毒治疗的长期不良反应。如今，HIV专科医生应该是一名全面的内科医生，或者需要良好的合作基础设施。HIV感染中的心血管危险因素包括血脂，尤其是抗病毒治疗下的高LDL水平。可以通过更换HIV治疗方案或添加降脂药物来管理这些因素。然而，吸烟习惯和高血压的正常化也很重要。患者中还存在其他重要的合并症，如乙型或丙型病毒性肝炎、肾病（HIV相关性或继发性）以及骨转换变化导致骨量和骨稳定性降低。其他方面包括疫苗接种状况以及对非HIV相关癌症的预防。
