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Human Immunodeficiency Virus (HIV)

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Care of Adults with Chronic Childhood Conditions

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Abstract

With the introduction of combination antiretroviral therapy (cART), people living with human immunodeficiency virus (HIV) have achieved tremendous gains in life expectancy. Persons with perinatal HIV infection now commonly live into adulthood but have comorbidities associated with pediatric HIV infection and acquired immunodeficiency syndrome (AIDS). Youth and young adults who have been behaviorally infected with HIV will face the physical and psychological challenges of a lifetime of HIV infection as they continue to age. Common comorbidities for adolescents and young adults with HIV include conditions specific to HIV such as lipodystrophy, opportunistic infections related to prolonged immunodeficiency, neurocognitive effects, and an increased incidence of certain cancers. In addition, people living with HIV are also at risk for the psychosocial stressors related to HIV infection including HIV-related stigma and concerns regarding disclosure of HIV status, mood disorders and substance abuse, and prevention of secondary HIV transmission. Physicians who care for adolescents and young adults will begin to see these patients in their practice panels and must be aware of the unique characteristics and medical concerns of youth with HIV infection as they age. Primary care physicians are ideal partners for HIV providers to address the chronic disease management issues of the aging perinatal HIV population and growing numbers of youth with new HIV infection.

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Author information

Authors and Affiliations

  1. Internal Medicine Residency, Department of Graduate Medical Education, Gwinnett Medical Center, 1000 Medical Center Blvd, Lawrenceville, GA, 30046, USA

    Kimberly Carter Bates

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  1. Kimberly Carter Bates
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Correspondence to Kimberly Carter Bates .

Editor information

Editors and Affiliations

  1. School of Medicine, Hofstra North Shore-LIJ School of Medicine, LAKE SUCCESS, New York, USA

    Mariecel Pilapil

  2. Mount Sinai School of Medicine , NEW YORK, New York, USA

    David E. DeLaet

  3. University of California Los Angeles , SANTA MONICA, California, USA

    Alice A. Kuo

  4. Baylor Clinic , HOUSTON, Texas, USA

    Cynthia Peacock

  5. Brigham and Women's Hospital , BOSTON, Massachusetts, USA

    Niraj Sharma

Appendix

Appendix

Human immunodeficiency virus (HIV) condition fact sheet

Definition

Human immunodeficiency virus (HIV) is a retrovirus that infects helper T lymphocytes and causes CD4 cell depletion resulting in a chronic immunodeficiency

• HIV causes AIDS (acquired immunodeficiency syndrome)

• Due to advances in treatment, HIV infection is now a chronic disease which is manageable with combination antiretroviral therapy (cART)

Epidemiology

• Advances in cART have resulted in extended life expectancy for those living with HIV disease

• Youth and young adults with perinatal HIV infection make up 18 % of cases of persons with HIV

• More than 40 % of perinatally infected persons have been diagnosed with AIDS during their lifetime

• Approximately 1 in 4 new HIV infections are in persons age 13–24, and sexual and ethnic minorities are significantly over-represented

Special considerations

Adolescents and young adults with HIV are at risk for the following conditions related to HIV disease and treatment

• Neurocognitive effects of prolonged HIV disease in perinatally infected persons

• Metabolic disease, such as diabetes and hyperlipidemia

• HPV-related malignancies

• Stigma and concerns with HIV disclosure

• Disease progression related to non-adherence to therapy

• Body image concerns from lipodystrophy

• Secondary HIV prevention

• Higher incidence of STI infection and substance abuse in certain populations, such as young men who have sex with men

 

Individuals are at heightened risk for chronic conditions, including

• Non-AIDS-defining malignancies such as HPV-related cancers (particularly anal cancers), lung cancers, and Hodgkin’s lymphoma

• Diabetes and hyperlipidemia

• Depression and anxiety

Recommended screening

Annual screening for

• Diabetes

• Sexually transmitted infections (STI)

• Mental health disorders and substance abuse

• Hyperlipidemia

• Cervical cancer in women (every 3 years after three consecutive normal screenings)

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Bates, K.C. (2016). Human Immunodeficiency Virus (HIV). In: Pilapil, M., DeLaet, D., Kuo, A., Peacock, C., Sharma, N. (eds) Care of Adults with Chronic Childhood Conditions. Springer, Cham. https://doi.org/10.1007/978-3-319-43827-6_11

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  • DOI: https://doi.org/10.1007/978-3-319-43827-6_11

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