'Looking after the Survivors': The Health of a Cohort of Long term HIV Patients 25 Years on.

BACKGROUND: Patients with Human Immunodeficiency Virus (HIV) infection have higher rates of cardiovascular disease, metabolic disorders and malignancy than their uninfected peers.

AIM: To survey the health of a South Australian cohort of long term HIV patients, who had been diagnosed with HIV prior to the availability of combination antiretroviral therapy (cART).

METHODS: Data from 88 patients was collected retrospectively across four domains: demographics, HIV history, antiretroviral medication and medical co-morbidity.

RESULTS: There were high rates of cardiovascular risk factors, in particular active smoking, dyslipidaemia and diabetes mellitus, which translated into a high rate of ischaemic heart disease and cerebrovascular accidents. A large proportion of the patients suffered depression and cognitive impairment. Approximately one fifth of the cohort had been diagnosed with a malignancy, with anal cancer being the most prevalent. Many patients had experienced permanent toxicity from antiretroviral therapy.

CONCLUSIONS: This study showed high rates of 'non-HIV morbidity' in a group of long term HIV patients in South Australia. Clinicians should aggressively modify cardiovascular risk factors, ensure appropriate immunisations, monitor mental health and consider targeted malignancy screening in these patients. A robust clinical infrastructure and multidisciplinary team is required to facilitate the complex care needs of long term HIV patients. This article is protected by copyright. All rights reserved.