HIV never walks alone! See the deadliest complications killing our patients.

On 26th  March 2015, Governor Mike Pence of Indiana declared an emergency in Scott County due to what was being described as the worst HIV outbreak in the state’s history. The cases were all caused by intravenous drug use, but some health officials fear that a rapid, short-term response will not be enough in the face of a large drug abuse problem. HIV stands for human immunodeficiency virus. The virus attacks the immune system, and decreases your ability to fight infections and disease. There are no treatments for people with HIV yet, but researchers are doing their best to develop effective therapies. We already have rather successful disease management programs, based on the control of HIV phase development via chemical medication, so people with HIV are living longer nowadays than ever. However, in the past years scientists start to observe the fact, that HIV patients are more likely to develop other health complications, such as cardiovascular, respiratory or even neurocognitive diseases. More shokingly,these are the most frequent causes of death in HIV patients. Let’s take a closer look on effects, these secondary diagnoses have on HIV-positive patients.

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Studies show, that the cardiovascular diseases (CVD) is the cause of death for as much as 20% of HIV patients. Why is it so? Because the buildup of soft plaque in arteries that nourish the heart is more common and extensive in HIV-infected men than HIV-uninfected men. That’s independent of established CVD risk factors. Looking at the figure above, we can see that the problem of additional diagnoses in HIV patients gains its recognition in clinical research. From the year 2000 to 2004 the number of papers published about CVD and respiratory diseases related to HIV was nearly the same, but from 2005, the number of papers for CVD grew faster. In 2013, there were more than 200 research papers published on CVD-HIV coincidence and the number is still growing. I seems, that the researchers are truly focused on this issue. We present you the most relevant research paper for CVD-HIV relationship: “Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease.” with 113 citations. Most of the CVD-HIV research is done in USA (738) followed by Italy(122) and Spain(88). The scientists with the greatest number of published research papers are Carl Grunfeld, Peter Reiss and Grace A. McComsey.

The pulmonary complications are yet another threat for HIV patients, as the lungs of HIV-positive individuals are affected by infections and tumors more often than general public. Reports describe, that more than 65% of patients have at least one respiratory issue during the course of their disease.  The number of publications for the respiratory diseases and HIV coincidence varies between 40 and 80 publications a year. However, we can see a newly emerging trend in the past few years. When we look at the number of publication for different countries, we can see that the USA are still at the top with 360 published research papers. The second place belongs to United Kingdom (93) and the third to France (81). The most cited publication in research of respiratory disease in HIV-positive patients is “Respiratory disease trends in the Pulmonary Complications of HIV Infection Study cohort. Pulmonary Complications of HIV Infection Study Group.” with 21 citations.

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On the first figure in this article, we can see that the field of neurocognitive diseases (NCDs) related to HIV is relatively young paradigm of research, but the number of publications are rising every year. Most of the research was done in the USA (259) other countries like Australia and United Kingdom have 10 times less research papers published on this topic. The most cited publication about relationship between HIV and NCDs is “Updated research nosology for HIV-associated neurocognitive disorders.” with 237 citations. HIV-associated NCDs can occur when HIV enters the nervous system and influences the health of nerve cells. This can damage the activity of nerves involved in: memory, language, attention, problem solving and decision making.

When we look at the number of publications in research of diseases related to HIV, we can observe that the scientific society gives more and more attention to this problems and tries to understand it in its fullest. This is very positive news, as a considerable percentage of deaths of HIV-positive patients is caused by the complications caused by secondary diagnoses. We hope that the therapies of the future, we will be able to slower or diminish the onset of named secondary diagnoses.