The leader of U2 received the Peace Prize

Nobel Peace Prize awarded in Paris, U2 leader Bono Award "Man Of Peace" for establishing a fund to combat AIDS and malaria, and work actively to write off debts of African countries, reported AFP.

Prize to musician was given by the Mayor of Paris Bertrand Delane. At the awarding ceremony attended by former South African president Frederik Willem de Klerk, Polish politician Lech Walesa, Irish politician John Hume.

"For me this is a very important award because, let me be honest, it is very close to the Nobel Peace Prize" - Bono said.

In 2007, the prize of peace "Man Of Peace" was awarded to George Clooney and Don Chidlu.

Awards took place at the annual three-day summit of Nobel laureates. One of the organizers of the summit in favor of Mikhail Gorbachev Foundation. Gorbachev himself was unable to attend the awarding ceremony for health reasons.

British activists need to stop the deportation of people with HIV

Two major charitable AIDS Service Organizations Britain - AHPN and NAT - urged the Government to review the policy of deporting people who have been diagnosed with HIV.

Representatives of organizations in conjunction with its appeal to the World Human Rights Day, celebrated on 10 December. Activists believe that you'd like to prevent the deportation of people with HIV in those countries where they would be prohibitively treatment.

Britain, as a member of Group of Eight, has signed a promise to provide universal access to HIV treatment for all who need it by 2010. At the same time, the British government deports people living with HIV without assurances that the country of destination for them will be available treatment, which is contrary to this promise. For many people living with HIV, lifting or suspension of the treatment is life-threatening.

Titise Code, executive director of AHPN, explains: "At the international level, Britain has become a leader in support of universal access to treatment for all who need it. But that leadership does not occur at home, where the practice of deporting people to countries without access to treatment. This violates the rights of HIV-positive people and questioned the intentions of the Government in respect of human rights. "

Deborah Jack, executive director of NAT, believes that "Human Rights Day, the British Government should immediately review the process of deportation, which does not guarantee people that their therapy against HIV will not be disrupted in Britain and the destination country. Deportation people living with HIV without regard to their treatment The Government has ignored the right to health and putting their lives at risk. "

Organization launched a campaign, which demands that the Government deferred the deportation of people living with HIV in the UK until the treatment becomes more affordable in their home country.

Earlier this year, the organization released a report NAT "The Myth of HIV-tourism", which belies the stereotype that people often emigrate to the UK just to get a costly treatment, such as therapy against HIV.

The vaccine Gardasil can protect young men from cancer

Pharmaceutical company Merck, announced last week, that it's vaccine against the human papilloma virus (HPV), and it is effective for boys and young men.

Initially, the vaccine Gardasil, was tested only among girls and women as well as it's main objective - to protect women against cervical cancer, which can cause HPV. This is the first test of vaccine for men.

HPV infections related to HIV infection. Among men, the virus can lead to anal cancer, which most often occurs in HIV-positive people.

The study was conducted by the University of California, San Francisco, as reported UCSF Today. The study involved 4,065 men and boys aged 16 to 26 years. The vaccine protects against four types of HPV - 6, 11, 16 and 18, which most often leads to cancer. Among the half of the participants who received the vaccine were 15 cases of infection, one of the varieties of the virus. In the control group receiving a placebo, was recorded 101 cases of infection.

Gardasil approved in the U.S. and Europe, they often vaccinate girls from 9 years and older in school vaccination programs. Previously it was shown that Gardasil effective in preventing HPV strains 16 and 18, which cause 70% of cases of cervical cancer. The vaccine also reduces the risk of genital warts - warts, other effects of HPV - 90%.

Although the vaccine is little tested on men, in some countries, its application for boys and men have already endorsed. Now pharmacy campaign going to apply for approval of the vaccine in the U.S. for men from 9 to 26 years to prevent genital warts and precancerous entities.

HPV can potentially lead to cancer penis, but the disease is relatively rare. Mass vaccination to prevent genital warts and cancer of the penis can not be justified in terms of value. But scientists note that there are other reasons for the vaccination of men. If vaccinating both men and women, it would drastically reduce the incidence of HPV in the general population.

Another reason for vaccination - anal cancer, which is particularly common among homosexual men. Most HIV-positive men have chronic HPV infection. For people with HIV both sexes, there is an increased risk of anal cancer. In addition, HPV is a risk factor for certain types of cancer of the mouth, which often occur in men.

The preparation of antibodies can stop AIDS: only monkeys

The group of scientists said that they have developed the drug can protect monkeys from immunodeficiency caused by HIV monkeys (SIO).
The virus is the closest relative of HIV, which leads to AIDS in humans. Nine rhesus macaque infected VIO, and then they were treated to new medication, and all of them, thanks to him, survived.

A new method of treatment aimed at preventing the virus "deceive" the immune system, said the site drugs.com. While there is no guarantee that a similar drug will do the same effective for humans. However, if this proves true, people with HIV will be able to renounce permanent receiving drugs suppress the virus - the drug will protect them from development stage of AIDS by the end of life.

This was announced by Research Rama Rao Amara, professor at Emory University. "Imagine you had to drink medicine every day, and now you wake up and realize that you do not need to drink now, no pills - is a huge breakthrough in the treatment" - he said.

In addition, according to Amara modern medicines against HIV are very expensive and they have potential side effects. Of course, existing drugs are very effective - they allow people with HIV stay healthy and lead a normal life. Nevertheless, there is always a risk that the virus will become resistant to taking drugs. "The virus is changing, and after a while drugs can stop working," - said Amara.

In the new study, Amara and his colleagues have introduced nine monkeys antibody that blocks the signal virus, "saying" immune cells - "do not kill me." This message appears on the surface of cells infected with the ODS, and cell-killers think - this is not the enemy, this friend.

" However, if the signal is blocked, the cell-killers immune systems are starting to do their work and destroy the virus.

Researchers have introduced four injections of antibodies monkeys for 10 days and then watched what happened. Monkeys that were infected with the ODS for 21 months, were able to almost completely suppress the virus.
The level of virus in their blood were low, monkeys survived, while most monkeys usually die from VIO during the first four months. "It's just amazing how you can dramatically change these cells killers. Now they have a really good cells", - said Amara.

However, monkeys, which now hopes for a new HIV treatment is now waiting for the sad fate - they put to sleep because scientists do not have the means to continue to support them and monitor them.

If the same treatment developed for people, the cost will be about 2000 dollars per dose, however, said Amara, the total cost of treatment will be less than that of modern therapies against HIV. Dr. Mark Connors, a specialist in the field of AIDS research, believes that the study "a true and very interesting." "I am confident that it will cause more heated debate, and within the next year we'll talk about that matter the results," - he said.

Even skeptics agree that this method of treatment can reduce the level of virus in the body, said Connors, who heads the office of the HIV-specific immunity at the National Institute of Allergy and Infectious Diseases USA.

Sam Connors said he was "cautiously optimistic" about what this drug can be applied to people, possibly in combination with other methods of treatment.

In the United States to register a new condom for women

As reported by Reuters, the Administration for food and medicines USA began its review of applications for the registration of a new, less expensive female condom to prevent unwanted pregnancies, HIV and other sexually transmitted infections.

Female condom FC2 was designed by the "Female Health Co".

It is made of synthetic rubber, which is similar to the material for male condoms, which makes production less labor and reduces its value.

Throughout the world, known male condoms, a variety of brands which cost from 50 cents to $ 2 per piece. However, many people do not even know that there are not only male but female condoms. Mostly female condoms less to spread because of high costs - from 2.80 to 4 dollars.

Now the company is trying to approve a new version of the female condom. "The whole idea is to increase their accessibility," - said Mary Ann Liper, counselor and former president of the company. However, the Administration for food and medicines demanded that the company hold a special clinical trials that show how FC2 effective in protecting against pregnancy and infections.

The company said that it was not conducted tests, because condoms are made from new material, but in other respects they are the same as the old female condoms, which are sold in the U.S. market. The company insists that additional testing is needed. The administration will now consider the matter again.

Female condoms are composed of a plastic ring on the ground, which is attached a condom. Inside a condom is a second plastic ring, which is mounted on the cervix and outer ring remains outside the body of women. The company complains that have not been able to achieve successful marketing of products, but now she is looking for a partnership with another company - producer of male condoms or pharmacy company, which funds HIV prevention programs.

The women's version of a condom offers women the opportunity to control their own protection - a woman enters a condom before sexual intercourse. In many poor countries have already approved and circulated a new version of condoms for HIV prevention. Female condoms also have advantages over men.

They rarely break, cover female genitals from the outside, they are less reduces sensitivity during sex.

Because of the AIDS epidemic, the Chinese residents of the village are forced to grow mushrooms

Villagers Venlou in the central Chinese province of Henan, face discriminatory treatment in relation to HIV / AIDS.

In the village live ordinary Chinese who, despite their talents and hard work, anywhere can not find work outside their district.

The fault to the prevailing image everywhere, that all residents of the town of HIV-positive. They did not want to hire, and that is grown on the side of the village, because of the prejudices little bad sale at the provincial markets.

Even visiting these places Wen Jiabao, Premier of State Council of China last month, when he shook the hand of a man with HIV and eat local vegetables, has not brought tangible results for the villagers to sell vegetable products, reported the newspaper "China Daily".

The AIDS epidemic has come to the province of Henan at the end of the last century. HIV began to spread in rural areas of the province, according to the newspaper, after the blood transfusion has not been peasants, seek medical help. Another explanation for the causes of mass spread of the virus among the villagers did not exist because the local population had no other risk factors.

The most problematic in this regard has been Village Venlou - 70% of village families, people living with HIV, which then many moved to the stage of AIDS. Over the past few years, hundreds of peasants died of diseases associated with AIDS. Villagers were left virtually without income. It has become very difficult to sell products as soon as the buyers found out where she is.

Local businessman Yue Dunfen organized peasants to grow mushrooms. However, sales of mushrooms in the markets is far too difficult - playing the role of "bad" image of the village, despite the fact that HIV-positive are only permitted to grow mushrooms, and collecting and dealing with crop farmers do not have the virus.

Yue Dunfen plans to sell Mushrooms foreign buyers, because, he said, more than tolerate relate to people with HIV.

Access to treatment for HIV / AIDS: first steps

Access to treatment for HIV / AIDS: first steps

Groups of people living with HIV public organizations and various associations have always been at the forefront of prevention and care from the very beginning of the AIDS epidemic. The mobilization of various organizations and people living with HIV helps to ensure the best quality of services in the field of HIV / AIDS. It also depends on change the world about AIDS and people living with HIV. Lack of access to modern HIV / AIDS in many regions - this is a problem whose solution is impossible without the involvement of community and government organizations, and groups of people with HIV/AIDS.

Access to treatment is difficult and tense area for several reasons:

Drugs such as anti-retrovirals and other essential medicines available to people in many parts of the world. Even if they are available, many factors make them unacceptable. These factors include: discrimination against people with HIV, the inadequacy of the medical facilities and other factors that prevent people receive treatment, which they need. Access to treatment is not only access to medicines, but also to other means: laboratory tests, syringes, condoms, etc.

Failure to enforce the right to health means that people with HIV and their loved ones, is organic choice for the treatment of HIV infection, if such a choice at all.


Anti-retrovirals have been able to radically change the length and quality of life for people living with HIV. But these same drugs have raised some important issues. Do the people living in poor regions, the right to receive medical treatment, on which depends their lives? If so, what can we do to this treatment has become affordable and acceptable? What should I change in the health system to enable the provision of expensive treatment?

Also often forgotten that there are other aspects of treatment, in addition to anti-retroviral drugs. For quality care, you need: housing, food, clean water, access to information, treatment of other infections, etc.

In medicine still believed that treatment - an issue which does not have the right to intervene themselves, patients and representatives of communities and community organizations. Experience shows, however, that the approach to treatment, based on the active role of community leads to the treatment process less mysterious and mythologize that "the laity can understand the purpose and limitations of drugs, and that only active participation of people with HIV can maintain their health.

The attitude and actions in the area of treatment

Safe and effective treatment of HIV / AIDS is vital for many people. That is why, attitudes and actions in the treatment of those who provide or receive care must also be safe and effective. Even drugs need to support the atmosphere to work well.

Underlying these actions must be "based on a relationship." Their goal - improving the quality of life of people with HIV. This two-sided process in which both sides should treat each other with trust and respect.

A relationship can arise not only from physicians and their patients. They also include family members, pharmacists, consultants, representatives of churches and many others. The establishment of such relations requires:

knowledge - understanding and information about the new treatment and drugs, HIV transmission, nutrition, living with HIV in general, etc.
skills - the ability to listen to others, make responsible decisions, advise, assess, etc.
attitude - an honest approach that promotes the attainment of power by people with HIV, based on humanity, tolerance and common sense.

Also important aspect of access to treatment is ethics - a code of conduct to inflict evil, reduce suffering and give people the opportunity to make decisions independently. This is particularly important in the treatment of HIV / AIDS, given all the complexities and contradictions related to this matter.

The introduction of ethics in access to treatment can be very effective. For example, you can not deal with access to treatment, not knowing the Constitution, national legislation on AIDS, the Convention of Human Rights, as well as all laws prohibiting discrimination.

Information on treatment


Full information on the treatment needed to ensure safe and effective care for HIV / AIDS. More information is needed and health workers and patients to help them cooperate with each other for access to adequate treatment, optimal for the patient. Without adequate information, is always the risk of improper treatment, medical errors and lack of treatment in principle.

Good information on the treatment consists of many different elements. There is no doubt that health workers need clear guidelines on the appointment and security products. As for people living with HIV, it did not have information about treatment options, they simply will not apply to him. All the people who have it, or otherwise relates to the treatment must have full information about the possibilities of medicine at the moment. Without it possible effective action to improve access to treatment.

Co-operation and willingness to be circulated in the area of treatment depends on what people know about the current treatment method of its actions, its positive and negative effects. There is a need to know how treatment would affect the daily lives of people, but it can cost as professionals and what preparations are needed for the appointment of treatment, a medical equipment and facilities may be needed.

People initially may be knowledge about the disease and treatment, but this information is often misleading. Information on treatment has already "runs" in different organizations and the community of HIV-positive. People learn from their experience and expertise of others. Also, patchy information appears in the media and other sources outside the medical field. However, this information is often unreliable. The representation of people on treatment there are serious gaps to be filled by various myths, which, in turn, hampers access to treatment. So in one seminar in Zambia, participants tried to portray their understanding of and treatment of diseases associated with HIV / AIDS. As a result, it turned out that among the participants, who were working in different organizations and represented community of people with HIV, there was a real knowledge and serious gaps. For example, no mention was made all preparations, often cited ineffective drugs, people confused brand names and official titles. Also, not all the participants emerged presentation that the treatment may take a person with HIV not only with the disease, but also to prevent their occurrence.

Treatment and individual groups

The life of every person with HIV is unique, she was influenced by various factors, it has various resources. Where possible, treatment of HIV / AIDS must be implemented in accordance with individual rights and personal needs.

Very often, services for the care and treatment do not take into account the needs of individual groups, especially those who reject society because of their age, sex, behavior, profession or status. Representatives of these groups face

When working with own groups, it is important that services meet the real needs of those whom they are intended to help. For example, injecting drug users may need advice on how drugs to treat HIV infection can interact with drugs. Moreover, in many cases, it is important not only take care of the needs of specific groups, but also to deal with possible discrimination by health workers and other people with HIV and society as a whole. Even if the differences in the care and treatment in relation to a particular group due to well-intentioned, they only reinforce prejudice and isolation. The approach to treatment must be holistic - it must meet the unique experience of the individual, rather than just diagnosing and discriminatory labels.

It also must take into account the needs of the families of those living with HIV. Thus, the treatment of HIV-positive parents directly affect the lives and welfare of their children, even if the children themselves do not have HIV infection. After all, in case an adult, the child will receive less care and concern, but if he is an adult, he himself will become a nurse. The families of HIV-positive, especially children - are another group of people in need in the modern treatment of HIV infection, even if they do not take it themselves.
even greater obstacles in obtaining treatment. For example, in India, women receive care only in second place after the men. In Ecuador, homosexual men can not get adequate medical care because of discrimination by doctors. In Russia and other countries of the former Soviet Union, injecting drug users are usually ineligible to receive anti-retroviral drugs, because it is believed that they were not able to comply with the complicated regimen.

Development cooperation

No person, organization or an entire sector can not make changes in the treatment of HIV / AIDS alone. Partnership is essential, and it will also help guarantee the effectiveness of action. The partnership is especially important in the treatment, because it guarantees that the measures taken is equal to the needs of people with HIV, and that different patterns of health (services for the prevention, reproductive health, HIV / AIDS, tuberculosis) are working to achieve a common goal.

The partnership should develop between the different groups: community of people with HIV, regional entities, religious organizations, pharmaceutical companies, representatives business and various media. For example, a network of positive people in India had worked closely with local authorities. The team of volunteers and consultants visited 3-4 network of local hospitals, providing support for people with HIV and increasing the knowledge and training of health workers. This has helped to significantly improve the quality of care for HIV in the region.

Involving people living with HIV

People with HIV are not just "take" treatment. They may also provide care, information, assessment of the situation and defend their interests. Involving people living with HIV as individuals and as groups become increasingly important. For example, a study in Ecuador showed that the participation of people with HIV to take decision help increase access to medicines. In Zambia, the involvement of people living with HIV prevention programs make the diagnosis of HIV infection earlier, allowing people to contact a doctor before any health problems.

Involving people living with HIV is important not only at the stage of program implementation, but also in the development phase, especially if it is to make the service more relevant and "friendly" for people with HIV. On the other hand, people with HIV play a central role in the advocacy of access to treatment. In the field of HIV-positive use of the expertise and skills, and his direct experience, for example, of side effects and compliance with treatment regimens.

Experience shows that the involvement of people living with HIV in the design, implementation and evaluation of the effectiveness of programs is vital to improve access to treatment for HIV / AIDS. People with HIV choose the degree of their participation. This can be either defending their own rights to treatment, as well as volunteering or permanent work in an organization dealing with the treatment.

Types of participation of people with HIV may also be different. It can be educational and advisory work on treatment. Here, people with HIV helps their personal experience and the opportunity to serve as positive role models for others. On the other hand, without the necessary preparation of their advice may facilitate the spread was not correct information.

Also, people with HIV may judged access to care among health workers and government representatives, speaking from the perspective of their own experience, which often leads to a constructive dialog between the parties.

Community Involvement

Involvement of people, decision-makers and ordinary citizens need to improve access to treatment. This can reduce the stigma and discrimination associated with HIV, and to ensure that the needs of people with HIV will be taken into account when allocating resources.

Community may be involved in work on access to treatment at different levels. Thus, they can participate in the evaluation of needs and progress in increasing access. They can provide support to various organizations and groups of people with HIV, for example, by providing them with resources and engaging in their work. Representatives of communities can become a volunteer organization or to support other private. For example, in Cambodia, the involvement of volunteers in providing psychosocial support to people affected by the epidemic, allowing health workers to devote his work exclusively health issues, also volunteers consultants were able to establish relationships with doctors and traditional healers, which was overcome mutual distrust between these groups .

Remember also that the political situation and economic opportunities are changing rapidly. These changes can make anti-etroviral treatment more affordable than ever before. But to anti-retroviral drugs actually became available community must "prepare" for them. To do this, it is necessary to understand the submission of these products, Existing in this community, to provide education on HIV / AIDS treatment to potential patients. It is not possible without the involvement of community as a whole and people with HIV. It also would require an active dialogue with people, decision makers, including those who work outside the health sector. It is imperative that the entire society has been growing awareness and knowledge about contemporary treatment of HIV infection and the need for its implementation.

What is immune reconstruction?

Studies show that if effective drugs against HIV, the immune system, in most cases, restores itself.

Immune reconstruction means that the organism is increasingly struggling with infections that otherwise could cause serious illness. Drugs control HIV, and it allows the body to increase the number of cells CD4, which shows the restoration of the immune system.

So what is a syndrome of immune reconstruction?

Remember that the immune system destroys HIV, and with the recovery of inflammatory processes are not well expressed. There arises a high temperature, redness, edema and the like, despite the presence of infectious. When the immune system is restored, the ability of these inflammatory processes returns. Consider the example LZ and eye infections. Treatment with antibiotics killed most of the microorganisms that cause infection eyes. Because the immune system LZ was destroyed, there was no inflammation.

When drugs against HIV strengthen the immune system, the body "felt" eye infections - organisms that remain after treatment with antibiotics. Sensing the presence of these organisms, recently restored the immune system launches inflammatory response, leading to fever, redness and edema eyes. Although the immune system LZ become more healthy, the eye condition had deteriorated ... in this irony immune deficiency syndrome reconstruction.

It is dangerous immune reconstruction?

Although the syndrome of immune reconstruction said on healing the immune system, it alone can be very dangerous. Depending on the exacerbation of infection it caused, it is necessary to appoint an aggressive treatment of the opportunists to prevent serious complications. In most cases, the syndrome of immune reconstruction of acute infection following:

- Pneumocystic pneumonia

- Herpes

- TSMV infection

- MAC infection

- Ulcerous lesions in the mouth

- TB

What should I do with syndrome of immune reconstruction?

Once again:
the restoration of the immune system - this is a good process and it should be retained, but with opportunistic infections and inflammatory processes must be as soon as possible to deal with.

Treatment with the syndrome of immune reconstruction following:

- Continuation of receiving antiretroviral therapy.

- Aggressive treatment of opportunistic infections: antibiotics or antiviral drugs.

- Short-receiving drugs based on steroids, which suppress inflammatory processes in the body.

Reconstruction immune deficiency syndrome - is a very complex and controversial issue because it raises "very high" effectiveness of therapy against HIV/AIDS. If there is such a problem, immediately contact your doctor, ask him to be more questions and participate in planning further treatment, which in the case of the syndrome should be very careful.

What manifests itself immune system work?

When the infective organism enters the body, takes place a few reactions that signal the immune system, it is time to fight infection. All these reactions collectively referred to as inflammatory reactions. Signs of inflammation, which show the work of the immune system include:

- Increasing the body temperature

- Swelling around the wound or place of infection

- Reddening skin lesions on the spot

- Allocation of pus and liquid from the place of infection

- Heat and pain at the site of infection

If a person's immune system damaged by HIV, such manifestations of the immune system may be poorly expressed or absent.

AIDS reconstruction

Antiretroviral therapy helps to maintain the immune system, and even at the stage of AIDS can restore the immune status and bring the health of the norm. But sometimes happens that a person with low immune status, despite the effective action of therapy, all of a sudden deterioration. This so-called "syndrome of immune reconstruction, which can be very dangerous, though rare. In this article, the American specialist Michael Kichoki is about what this syndrome and what to do with his appearance.

There is LZ with HIV, hand with the opportunistic diseases - the defeat of the right eye due to TSMV infection. After several days of treatment of eye disease significantly reduced and LZ discharged from the hospital. A week later, he turned to a specialist on HIV and began receiving standard antiretroviral therapy. It was only logical. His eyes recovered, and his aim was to suppress reproduction of a doctor with HIV in his body to keep the immune system and prevent such infections in the future.

However, after several weeks of receiving anti-retro viral drugs, he developed fever, visual impairment and swelling around the eye. Strangely, it was that the number of CD4 he has begun to rise very rapidly, immediately after the start of treatment. What's happening? His immune system is restored, but the eye condition has deteriorated significantly. LZ asked the doctor, and he was diagnosed - immune deficiency syndrome reconstruction.

What is immune deficiency syndrome reconstruction? Reconstruction of literally rebuilding. It sounds like something good, why did exacerbation LZ has an eye infection? To understand this strange and paradoxical syndrome, you need to first understand the work of the immune system.

The immune system

The immune system - is layered system to protect the body from various infections. The immune system includes several types of cells and processes that recognize and neutralize bacteria, parasites and viruses. Unfortunately, when HIV is happening damage the immune system, because HIV is attacking one of its cells - cells CD4. So if you have HIV need to monitor levels of CD4, the higher the level of CD4: the better your immune system works.

Principal HIV/AIDS-associated cardiovascular abnormalities

1.Type. Dilated cardiomyopathy.

Possible etiologies and associations:
HIV/AIDS, Toxoplasma gondii, Coxsackievirus group B,Epstein-Barr virus, Cytomegalovirus, Adenovirus
Autoimmune response to infection
Drug-related
Cocaine, possibly nucleoside analogs
IL-2, doxorubicin, interferon
Metabolic/endocrine
Nutritional deficiency/wasting
Selenium, B12, carnitine
Thyroid hormone, growth hormone
Adrenal insufficiency, hyperinsulinemia
Cytokines
TNF-, nitric oxide, TGF-, endothelin-1
Hypothermia
Hyperthermia
Autonomic insufficiency
Encephalopathy
Acquired immunodeficiency
HIV/AIDS viral load, length of immunosuppression

Incidence:
15.9 patients/1,000 asymptomatic
HIV/AIDS- infected persons before the introduction of HAART

2 Type. Coronary heart disease.

Possible etiologies and associations:
Protease-inhibitor-induced metabolic and coagulative disorders. Arteritis

Incidence:
Studies on the risk of coronary heart
disease among HIV/AIDS-infected individuals receiving protease inhibitor including HAART have not shown a consistent association


3Type. Systemic arterial hypertension.

Possible etiologies and associations:
HIV/AIDS-induced endothelial dysfunction.
Vasculitis in small, medium, and large vessels in the form of leukocytoclastic vasculitis; atherosclerosis secondaryto HAART;
aneurysms of the large vessels such as the carotid, femoral, and abdominal aorta with impairment of flow to the renal arteries; PI-induced insulin resistance with increased sympathetic activity and sodium retention

Incidence:
20%–25% of HIV-infected persons before the introduction of HAART Up to 74% in HIV/AIDS-infected persons with HAART-related metabolic syndrome


4Type. Pericardial effusion.

Possible etiologies and associations:

Bacteria: Staphylococcus, Streptococcus, Proteus,Nocardia, Pseudomonas, Klebsiella Enterococcus, Listeria, Mycobacteria (Mycobacterium tuberculosis, Mycobacterium avium intracellulare, Mycobacterium kansaii)
Viral pathogens
HIV, herpes simplex virus, herpes simplex
virus type 2, cytomegalovirus
Other pathogens
Cryptococcus, Toxoplasma, Histoplasma
Malignancy
Kaposi’s sarcoma
Malignant lymphoma
Capillary leak/wasting/malnutrition
Hypothyroidism
Prolonged acquired immunodeficiency

Incidence:
11%/year in asymptomatic AIDS patients before the introduction of HAART

Congenital Cardiovascular Malformations in HIV-Infected Children

Most pediatric patients with HIV are infected in the perinatal period. In a prospective, longitudinal, multi center study, diagnostic echo cardiograms were performed at 4- to 6-month intervals on two cohorts of children exposed to maternal HIV-1 infection: (a) a neonatal cohort of 90 HIV infected, 449 HIV-uninfected, and 19 HIV-indeterminate children; and (b) an older HIV-infected cohort of 201 children with vertically transmitted HIV-1 infection recruited after 28 days of age.

In the neonatal cohort, 36 lesions were seen in 36 patients, yielding an overall congenital cardiovascular malformation prevalence of 6.5% (36/558), with an 8.9% (8/90) prevalence in HIV-infected children and a 5.6% (25/449) prevalence in HIV-uninfected children [3]. Two children (2/558, 0.4%) had cyanotic lesions. In the older HIV-infected cohort, there was a congenital cardiovascular mail information prevalence of 7.5% (15/201). The distribution of lesions did not differ significantly
between the groups. There was no statistically significant difference in congenital cardiovascular
malformation prevalence in the HIV-infected compared to the HIV-uninfected children born to HIV-infected women. With the use of early screening echo cardiography, rates of congenital cardiovascular malformations in both the HIV-infected and HIV-uninfected children were five- to tenfold higher than rates reported in population-based epidemiologic studies, but not higher than in normal populations similarly screened.

Evolution of the Involvement of the Cardiovascular System in HIV/AIDS Infection

Cardiac illness related to human immunodeficiency virus (HIV) infection tends to occur late in the disease course and is therefore becoming more prevalent as therapy of the viral infection and longevity improve. Autopsy series and retrospective analysis
performed before the introduction of highly active anti-retroviral therapy (HAART) regimens suggest that cardiac lesions are present in 25%–75% of patients with acquired immunodeficiency syndrome (AIDS). HAART regimens have significantly modified the course of HIV disease, with longer survival rates and improvement of life quality in HIV infected subjects expected. However, early data
raised concerns about HAART being associated with an increase in both peripheral and coronary arterial diseases. HAART is only available to a minority of HIV-infected individuals worldwide, and studies
prior to HAART therapy remain globally applicable.
As 36.1 million adults and children are estimated to be living with HIV/AIDS and 5.3 million adults and children are estimated to have been newly infected with HIV during the year 2000, HIV-associated symptomatic heart failure may become one of the leading causes of heart failure worldwide. A variety of potential etiologies have been postulated for HIV-related heart disease, including myocardial infection
with HIV itself, opportunistic infections, viral infections, autoimmune response to viral infection, drug related cardiology, nutritional deficiencies, and prolonged immune suppression.