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Morbidität und Mortalität der HIV-Infektion

Morbidity and mortality in HIV infection

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Zusammenfassung

Morbidität und Mortalität von HIV-infizierten Menschen haben seit 1996 aufgrund der antiretroviralen Kombinationstherapie (cART) dramatisch abgenommen. Die HIV-Infektion wurde somit zu einer chronischen, ambulant behandelbaren und meist asymptomatischen Krankheit mit praktisch normaler Lebenserwartung. Ein Hauptgrund der verbleibenden Morbidität und Sterblichkeit ist, dass die HIV-Infektion in etwa 20% der Fälle spät diagnostiziert bzw. therapiert wird. Oft liegt zu diesem Zeitpunkt die CD4-Zellzahl bereits unter der Schwelle von 200 Zellen/µl und/oder AIDS-definierende Krankheiten haben sich manifestiert. Weitere Gründe für die verbleibende Morbidität und Mortalität sind Komorbiditäten, insbesondere die Koinfektion mit einer viralen Hepatitis und Tumoren bei älteren Patienten. Durch die verbesserte Prognose nimmt das Alter HIV-infizierter Menschen zu. Dies bedeutet aufgrund von Komorbiditäten und sozioökonomischen Kosten eine erhebliche Herausforderung für die Zukunft.

Abstract

Combination antiretroviral therapy (cART) has dramatically improved the prognosis of HIV-infected individuals, with a close to a normal life expectancy in a significant proportion of treated individuals. Upon start of cART, HIV-induced immune deficiency can be prevented or, if already present, reconstituted. Remaining morbidity and mortality is partly due to the late diagnosis of HIV infection or late presentation of patients, when CD4-T-cells have already fallen below 200 cells/µl and/or AIDS-defining conditions have manifested. Further reasons for remaining morbidity and mortality are related to co-morbidities such as viral hepatitis and tumors, particularly in older patients. As HIV-infected patients become older, increasing co-morbidities and socio-economic costs may become a challenge in the future.

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  1. Klinik für Infektiologie und Spitalhygiene, Universitätsspital Basel, Petersgraben 4, 4031, Basel, Schweiz

    M. Stöckle, L. Elzi, J.K. Rockstroh &  M. Battegay

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  1. M. Stöckle
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  2. L. Elzi
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  3. J.K. Rockstroh
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  4. M. Battegay
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Correspondence to M. Battegay.

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Stöckle, M., Elzi, L., Rockstroh, J. et al. Morbidität und Mortalität der HIV-Infektion. Internist 53, 1151–1156 (2012). https://doi.org/10.1007/s00108-011-2990-5

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