Anti-HIV treatment

Side-effects

All medicines can cause side-effects and the drugs used to treat HIV are no exception.

Not only can antiretrovirals cause unpleasant short-term side-effects, they have also been linked with some longer-term side-effects and these can involve a risk of serious illness.

There is now good evidence demonstrating a link between long-term anti-HIV treatment and an increased risk of heart disease. The good news is that this risk can be managed by things like not smoking, taking exercise and eating a good diet.

Now a study suggests that a number of factors may actually contribute to the heart disease risk seen in people with HIV. Anti-HIV treatment was one of these factors, but so too was being over-weight, a traditional risk-factor for heart disease. A low income was also identified as being a risk for heart disease.

Cancer

Cancer has always been a worry for people with HIV. Thankfully, effective anti-HIV treatment means that the AIDS-defining cancers, Kaposi’s sarcoma and non-Hodgkin’s lymphoma are now quite rare in the UK. But there is some evidence that people with HIV may have an increased risk of some other cancers. Some of these cancers are linked to infections, and doctors think that the long-term immune suppression that HIV causes increases the risk of other cancers.

Draft guidelines have been prepared for British HIV doctors specifying the sort of care an HIV-positive person diagnosed with cancer should receive. This care should include:

**Referral to a specialist centre with expertise treating cancer in people with HIV.

**Care by a team involving HIV doctors, cancer specialists, blood specialists and palliative care.

**Prompt treatment, with an appointment with a cancer expert within two weeks of referral.

The draft guidelines also set out how some of the more common cancers seen in people with HIV should be treated. These cancers include Kaposi’s sarcoma, non-Hodgkin’s lymphoma, cervical cancer, anal cancer , Hodgkin’s lymphoma, testicular cancer, lung cancer and liver cancer.