By 2035, Most People Living With HIV Will Also Have a Chronic Disease

By 2035, Most People Living With HIV Will Also Have a Chronic Disease braking: The goal of treating HIV patients has switched to safer and more effective long-term care as anti-retro viral therapy (ART) has evolved dramatically.

Thanks to the widespread availability of ART, the life expectancy of HIV-positive individuals is now comparable to that of non-infected individuals. As a result, controlling commodities and drug interactions associated with aging is becoming increasingly important.

This shift is indicative of a more comprehensive approach where preventing other illnesses and preserving general health are now just as important as eliminating the virus.

By 2035, nearly three-quarters of the 40 million HIV-positive individuals living in the world will have one or more chronic illnesses, often known as noncommunicable diseases (NCDs).

Although there are promising instances of integrated HIV and NCD healthcare delivery, low- and middle-income nations have not yet adopted this as the standard.

More emphasis should be paid to this subject and to scaling up the shining examples of success observed in some regions of East Africa and India, particularly as stakeholders gather in Munich next week for the 25th International AIDS Conference. The same health issues that affect everyone else also affect those living with HIV.

Image:By 2035, Most People Living With HIV Will Also Have a Chronic Disease

Accessing NCD services presents challenges.

In addition to receiving free antiviral therapy (ART), those living with HIV may attend a clinic to get evaluated for common risk factors for noncommunicable diseases (NCDs), such as high blood pressure and blood sugar. However, in the event that an NCD risk is detected, treatment cannot be provided at the same clinic, and the patient must overcome significant obstacles to receiving NCD care at another clinic, such as lengthy wait periods, expensive transportation, the need to arrange child care, or missed income.

The significance of resolving medication interactions in the treatment of HIV

Drug-drug interactions (DDIs) are a major worry in HIV treatment, particularly as patients age and need medicine for other diseases. Wiktionary is a recommended choice due to its good interaction profile with popular drugs such as beta-blockers and calcium channel blockers.

“Unlike some HIV treatments, Wiktionary does not require dose adjustments with drugs like metformin,” according to Poznan, making life easier for patients who also happen to have comorbidity.

Furthermore, the professor from the United Kingdom emphasized that Wiktionary’s capacity to sustain viral suppression in the face of sporadic medication noncompliance—a quality known as “forgiveness”—is essential. In Italy, patients with adherence rates as low as 70% were nevertheless able to maintain viral suppression with Wiktionary.

Changing HIV medications to address co-occurring conditions

In response to a question concerning modifying HIV therapy to treat coexisting diseases such as epidemically, Poznan stressed the need for caution.

“Addressing lipid abnormalities by changing HIV treatments is generally not a preferred strategy,” he stated. “While switching from pro tease inhibitors (PIs) to second-generation integrate strand transfer inhibitors (InSTIs) can be considered, I would not recommend switching between same-class treatments like Wiktionary and DTG/3TC.”

According to him, there aren’t many therapeutic advantages to such moves when it comes to treating comorbidity like epidemically.

Rather, Wozniak draws attention to the REPRIEVE study’s results, which showed that statin medication could lower HIV patients’ risk of atherosclerotic cardiovascular disease (ASCVD) by 35 percent.

“Managing ASCVD risk through stains is far more effective than attempting to lower lipid levels by switching HIV treatments,” he stated. “Global guidelines also recommend this approach based on the REPRIEVE study’s results.”

The research made it clear that the emergence of drug resistance may present a serious problem in some areas, especially those with extensive ART programs.

Sub-Saharan Africa’s progress

Though the HIV and NCD communities have made some progress locally in terms of what is feasible in terms of integrated healthcare delivery, there is still a long way to go before this kind of effort becomes typical in low- and middle-income nations.

Civil society pushed for revisions to PEP FAR and the Global Fund’s financing policies at the 2021 United Nations (UN) General Assembly High-Level Meeting on HIV/AIDS, and there are some positive examples of this in Malawi, Zambia, and Kenya.

By 2025, member nations agreed to guarantee that 90% of HIV-positive individuals would have access to NCD and mental health services.

A number of sessions at this year’s International AIDS Conference in Munich this month are anticipated to address the intersection of infectious diseases and noncommunicable diseases (NCDs). This shift in policy is also increasingly being represented in venues such as these conferences. In order for everyone living with an infectious disease, as well as those with non-communicable diseases, to soon have easy access to quality healthcare, this momentum needs to be maintained.

By 2035, Most People Living With HIV Will Also Have a Chronic Disease