Multidisciplinary Collaborative Integrated Management of Increasingly Prominent HIV Complications in the Post-cART Era

L Lin; TS Li


HIV Medicine. 2020;21(11):683-691. 

In This Article


HIV's direct damage to human cells, chronic abnormal inflammatory activation after HIV infection, long-term drug side effects caused by cART and persistent reservoirs cause systemic complications in PLWH (Figure 1). AIDS is a chronic inflammatory disease, and the continuous activation of the immune system is one of the most important immunopathological changes of HIV/AIDS throughout the course of the disease. Treating the chronic abnormal immune activation of AIDS will certainly improve the long-term prognosis of patients. Regarding the suppression of inflammation and immune activation, there is currently no effective method. Combining clinical practice, we preliminarily found that Tripterygium wilfordii can suppress immune activation and improve immune reconstruction, providing a new direction for the treatment of AIDS. Nevertheless, the management of the complications of HIV infection will play a major part in improving the survival treatment and prognosis of patients in future. The joint participation of doctors from different departments of general hospitals in the management of comorbidities is the main theme for future improvement of quality of life and prognosis for PLWH.

Figure 1.

Multisystem complications of HIV infection. cART, combination antiretroviral therapy; HBV, hepatitis B virus; HCV, hepatitis C virus; NVP, nevirapine; ZDV, zidovudine; ABC, abacavir; EFV, efavirenz; PI, protease inhibitor; AS, atherosclerosis; TF, tissue factors; CSF, cerebrospinal fluid; CKD, chronic kidney disease; TDF, tenofovir; GFR, glomerular filtration rate; BMD, bone mineral density; DBP, vitamin D-binding protein; 25OHD,25-OH vitamin D; PTH, parathyroid hormone; IFG, impaired fasting glucose; BMC, bone mineral content; LM, lean mass; d4T, stavudine; ddI, didanosine. [Colour figure can be viewed at]