HIV associated co-morbidities Flashcards
which cytokine is a strong predictor of mortality in HIV comorbidities
IL-6
triglycerides/cholesterol over ______ is considered abnormal lipids
200
optimal LDL, HDL, and total cholesterol?
LDL 40
total
HIV is a major risk for ____ (regarding CV system)
coronary artery disease (CAD)
what ART drug type also increases risk of CAD?
if patient has lipid issues, put them on a ___ instead
protease inhibitors
integrase inhibitor
how does HIV cause lipid issues/CAD?
chronic inflammation –> inflamed vessels trap more plaque
decreased lipolysis d/t mitochondrial dysfunction, altered regulation of nuclear receptors controlling lipid metabolism and inflammation
if TG are >1000, it is probably due to
pancreatitis
_____ syndrome is highly associated with HIV
syndrome consists of….
metabolic
abdominal obesity, high TGs (>150), high BP, low HDL, elevated fasting blood glucose (>110)
how does HIV cause renal disease?
after infection you get circulating immune complexes that can cause kidney damage
HIVAN
HIV associated nephropathy
HIV infection of glomerular endothelial and mesangial cells
renal biopsy shows collapsing focal glomerulosclerosis with tubulointerstitial injury
presents with nephrotic proteinuria (>3g/day), rapid rise in creatinine, large kidneys, no edema, normotensive, hypoglobulinemia, progresses to ESRD in months
HIV associated IgA nephropathy
igA antibodies directed against HIV antigen as part of early immunologic response –> circulating IgA complexes
presents with proteinuria, hematuria, and renal insufficiency
biopsy shows IgA deposits in mesangium and capillary walls (immunofluorescence), dense deposits, thickened foot processes, and expansion of mesangial matrix
in HIV, bones show ______
decreased BMD
osteonecrosis (avascular necrosis)
which ART drug causes a drop in BMD leading to osteopenia/osteoporosis
tenofovir
treat decreased BMD with
bisphosphonates and vitamin D
to avoid CVD in HIV patients what bad habit should be stopped?
smoking
