Endocrinopathies in HIV, AIDS and HAART

Excerpt

The United Nations AIDS Report in 2012 states that there are 34 million people living in the world with HIV/AIDS at the end of 2011; of these 69 % live in sub-Saharan Africa [1]. The Caribbean islands, Eastern Europe and Central Asia are the next three most affected regions of the world. The rate of new infections HIV has decreased to 2.5 million per year. In 2011 the number of people dying from AIDS had fallen down to 1.7 million from 2.3 million in 2005. The number of children who got infected with HIV was approximately 330,000 which have significantly fallen in the last 10 years. New perinatal HIV cases have substantially decreased due to HIV education, screening for HIV in pregnancy, peripartum, intrapartum care for HIV infected mother, formula feeding, postpartum care of the infant and new HAART medications. HIV infection has progressed from an acute disease to a chronic illness with developments in anti-retroviral therapies (HAART) along with better prophylaxis and treatment of opportunistic infections are the main contributors to the above advances [2]. In centers such as ours in Brooklyn, a significant cohort of long term survivors of perinatal HIV as well as a concentration large numbers of adults with HIV/AIDS help highlight the evolving clinical picture of this chronic disease and the impact of long term exposure to antiretroviral medications. There is an increase in morbidity and mortality due to secondary issues such as endocrine dys-regulation, although hormonal misbalance is not commonly seen. HIV and AIDS do involve almost all of the hormonal systems and axis (Fig. 1 and Table 1).

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