HIV Co-Morbidities and Multi-Morbidities

Several challenges confront those patients living and growing older with HIV disease with regard to non-communicable diseases, including cancer, addictive behaviors, fracture prevalence, heart disease and affective disorders, that present physical and mental health problems among the HIV positive [1-5]. Indeed, frailty and a conglomeration of behavioral risk factors are associated with multisystem co-morbid vulnerability that predict survival and multi-morbidity incidence among patients [6,7]. In a cohort of Romanian HIV patients, StreinuCercel et al. [8] observed moderately high prevalence of chronic renal disorders accompanied by moderately low occurrence of osteopenia and osteoporosis in comparison with these patents from other European countries with smoking addict an important risk factor renal and cardiac conditions, as well as impaired bone metabolism [9], for further bone health co-morbidities). Bolduc et al. [10] have listed several medical complications and multi-morbidities accompanied by multiple infection risk, including Pneumocystis jirocii, pneumonia, candida esophagitis, toxoplasmic encephalitis, tuberculosis, crytococcal meningitis, disseminate Mycobacterium avium complex, and cytomegalovirus retinitis, as well as ‘wasting’ syndrome and HIVencephalitis. According to the definitive study performed by Kilbourne et al. [11] among the most commonly observed HIV comorbidities presented by patients are to be included: oral candidiasis (21%), peripheral neuropathy (16%), and herpes zoster (16%) whereas those general medical comorbidities involved chemical hepatitis (53%), hypertension (24%), and hyperlipidemia (17%) with neuropsychiatric comorbidities offering a greater burden of disease among HIV-infected patients indicating that 32% of patients presented anxiety, 4% mania, 4% schizophrenia, and 11% cognitive impairment/dementia although estimations seem bedeviled by variations in symptom expression [12]. The seriousness of these latter cognitive deficits appears to constitute an especially heavy burden for everyday functioning and quality-oflife parameters [13,14]. The etiopathogenesis of the neuropsychiatric comorbidities, most particularly depressiveness and mood disorders, among HIV-infected patients affects deleteriously and markedly the quality-of-life, medication compliance, and disease prognosis in those afflicted; not least of all, the prevailing relationships between HIVrelated stigma, HIV-disclosure, social support networks, and mood and depression among patients await description and expression [15]. The situation is rendered even more serious in view of the inadequacy of certain regional public health medical services especially among minorities and vulnerable groups that require more effective health practices and long-term policies [16].