The HIV positive population has many problems and we are the ones who are getting old for the first time
HIV Population Positive Aging And Suffering
As the national population of people living with HIV-positive (The text is set in the US) continues to age, rheumatologists are increasingly called to manage routine care for illness crystalline, osteoarthritis, soft tissue rheumatism and other conditions, according to Leonard Calabrese, DO, of the Cleveland Clinic.
"HIV is an infection that is descended," Calabrese told participants at the Biologic Therapies Summit. "There are rare inflammatory complications that need aggressive therapy.
HIV Positive Population Aging with Rheumatologic Complications
Second, the HIV-infected population is aging, and they will have many rheumatic problems - they have osteoarthritis, rheumatic polymyalgia, gout and other conditions. They also have drug interactions that are very important and hopefully they are disappearing. There are also some new complications, such as the presence of osteoporosis, which has been a problem. "
Although a study published in 2017 in Arthritis Care & Research has demonstrated that a patient with HIV can be treated safely and effectively with a TNF-alpha inhibitor in current HIV practices - including aggressive CART, controlling the virus with a good CD4 cell response - as monotherapy, other interaction problems drugs are "formidable," according to Calabrese.
"There are now more of 35 drugs used to treat HIV in different combinations," he said. "If you are a patient with HIV medications and need to use anything from glucocorticoids to antimetabolites, call your pharmacist. It is absolutely imperative because some of the drug interactions are profound. "
Drugs that treat HIV generally carry the same warning notes as those of patients who are not infected with HIV, with several warnings, Calabrese said. For example, patients treated with ritonavir or cobicistat should avoid glucocorticoids.
There are several pharmacological thrusters, such as ritonavir and cobicistat, which may increase the area under the glucocorticoid curve in 400%!
In addition, he recommended caution when using methotrexate in patients with HIV, as several drugs for HIV.
And this includes cobicistat, darunavir, lopinavir, ritonavir and saquinavir.
As they may increase serum concentration and absorption of methotrexate, as well as decrease elimination and improve distribution.
Bullshit Or Death Threat?
Just look: I desperately yearned for antiretrovirals, and when they came, Dr. Patrícia Maia Cippollari had to "convince me to take them"! Because? Simple. By the time I took the first of those tablets, I officially became what I was given as a definition factor and do not read the red line below if you do not have the "strong spirit."
I would officially become "the AIDS-addicted garbage" given to me as a brand and my beautiful little face of Casanova!
And the worst! I had read the bull of the IDD and, among all the dangers that the bull had snorted and hailed the "little scary thing":
And Doctor Paty would tell me: If you feel pain in the abdomen stop the medication and come here immediately!
None of this was in the script I had imagined for myself, if I were to get HIV (The Inevitable)
"A recent group of AIDS clinical trials that only looked at methotrexate as a potential anti-cardiovascular disease progression agent."
But it showed significant toxicity, with lymphopenia and loss of CD4 cells, "said Calabrese. "This matches our clinical observations made over the course of several decades. So when we need to use aggressive therapy for things, particularly inflammatory arthritis, which is still occasionally seen, we use TNF monotherapy. "
Finally, Calabrese emphasized that almost all patients between 15 and 65 years should be tested for HIV.
Even though they are not at great risk of contracting the virus, according to the recommendations of the US Preventive Services Task Force.
Thus was my relationship with DDI and AZT
"If you find yourself selecting someone to hepatitis C or hepatitis B, and they are between the ages of 15 and 65 years, the guidelines are that you ask if they have already been tested for HIV, and if they did not, you include this in the mix too, "he said. "It would be a good remedy and a good accompaniment." - by Jason Laday
Calabrese L. Chronic viral disease (HIV, HCV, HBV) and rheumatologist. Presented at: Biologic Therapies Summit VIII; 16 to 17 May of 2019; Cleveland, Ohio.
Disclosure: Calabrese reports consulting fees from AbbVie, Bristol-Myers Squibb, Genentech / Roche, GlaxoSmithKline, Horizon, Janssen, Novartis, Pfizer, Regeneron, Sanofi Aventis and UCB. and AbbVie, Bristol-Myers Squibb, Crescendo, Genentech / Roche, Janssen and Novartis.
Translated by Claudio Souza, the original Aging HIV population face complicated rheumatologic care originally published in May 22, 2019.
I do not have any commercial interest represented in this publication, as well as in any other already published in this blog and I will make it very expensive tomorrow, Friday, as soon as my eyes open and I get out of the amitril swirl.
Have you received your diagnostic reagent and are you scared? Do you think your life is over? Are you having thoughts "of the type clueless"?
You need to get your hopes up!
Understand that my resilience was built one day at a time, one illness after another, one SUSAN AFTER THE OTHER!
Resilience is not something you are born with! You ROW IT! One fall after another. For every fall inevitably follows a new rebound!
Shake the dust off!
And Turn Around!
Your doctor, your doctor can do a lot for you!
Your family, if you have any, because there is not one left for me, they can or can not do something for you.
God could do everything for you!
But it's up to you to decide to go ahead or sit on the curb!
Do you think I talk too much? Please read my outdated medical history! 🙂 It may take a little while!
And as for Health, it is a Right of All and a Duty of the State