We fully agree with Hagmann and colleagues regarding the need to further assess the positive isolated anti-HBc, and support the management strategy that they highlighted to identify possible situations of viral reactivation. “
“The increase in the life expectancy achieved following the introduction

of more effective antiretroviral therapy (ART) in recent years now means that the HIV-infected population are for the first time being exposed to the age-related diseases that affect the general population. Nevertheless, the prevalence of these diseases (which include cardiovascular disease, dyslipidaemia, glucose intolerance and diabetes) is higher, and their onset earlier in the HIV population, probably due to the complex interplay between HIV infection, coinfection with hepatitis B and C, and ART. As a result, HIV

physicians are Ipilimumab supplier now required to adopt a new approach to the management of HIV, which involves screening and regular monitoring of all HIV-infected individuals for the presence of comorbidities and prompt referral to other clinical specialties when required. If this challenge to patient management is to be overcome, it is clear that educating physicians in the diagnosis and treatment of age-associated comorbidities selleck chemicals is essential, either through ongoing programmes such as the HIV and the Body initiative, an overarching independent medical education programme established in 2007 and overseen by an independent Steering Committee, organized and funded by Gilead, and/or through N-acetylglucosamine-1-phosphate transferase internal training. To assist in this process, this article provides an overview of common comorbidities affecting HIV-infected persons and provides practical guidance on their management. The introduction of effective combination antiretroviral therapy (ART) for the treatment of HIV infection means that patients now have much greater life expectancies [1]. However, mortality rates for HIV-infected patients are three to 15 times

higher than those of the general population [2]. While some of this excess mortality can be attributed to immunodeficiency, more than half of these deaths are not AIDS-related [3]. For the first time, HIV-infected patients are being exposed to the age-related diseases that affect the non-HIV-infected population; for example, cardiovascular disease (CVD), dyslipidaemia, glucose intolerance and diabetes. The prevalence of these conditions may be increased by the premature ageing effect of HIV infection on the immune system [4] and may mean that age-related metabolic comorbidities are encountered earlier than in the noninfected population. Progression to severe disease may also be accelerated in HIV-infected patients when compared with the general population as a result of coinfection with hepatitis B virus (HBV) or hepatitis C virus (HCV) and certain lifestyle factors; for example, cigarette smoking and alcohol consumption [1].