Pacientų, infekuotų ŽIV, lėtinė uždegiminė būklė

Currently, HIV positive patients have an expected lifespan moderately shorter than non-HIV individuals. Consequently, the effects of ageing on HIV positive individuals have begun to be apparent. The appropriate management of co-morbidities, which include cardiovascular, pulmonary, hepatic, metabolic, neoplastic, renal, bone, central nervous system disorders as well as sexual dysfunction, has increasingly become an integral part of the overall management of individuals living with HIV. Potential contributors to co-morbidity pathogenesis include a higher prevalence of recognised risk factors, ART-exposure and toxicity, HIV itself as well as immune dysfunction/dysregulation and chronic immune activation/inflammation, associated with HIV or other co-infections (e.g. CMV, HCV). This inflammation is especially obvious in older adults with chronic, well-treated HIV infection; thus, patients aged more than 50 years may undergo pathologies that normally affect much older individuals. The chronic inflammation and the persistent immune activation can be displayed in HIV positive patients related to the premature ageing, development of cardiovascular diseases and neurocognitive disorders. The mechanism(s) underlying the immune activation and chronic inflammation are poorly understood, but assumedly resulting from both direct and indirect effects of HIV. In the primary infection appears that the immune system, at the level of the intestine, is permanently damaged, resulting in bacterial translocation, therefore this situation causes a persistently activated inflammatory and immunological state