Secondary complications and co-infections in the HIV-infected adolescent in the antiretroviral era

• Published in: Current opinion in infectious diseases Vol. 24; no. 3; p. 212
• Main Authors: Ross, Allison C, Camacho-Gonzalez, Andres, Chahroudi, Ann, Chakraborty, Rana
• Format: Journal Article
• Language: English
• Published: United States 01.06.2011
• Subjects: Adolescent; AIDS-Associated Nephropathy - epidemiology; AIDS-Associated Nephropathy - prevention & control; AIDS-Related Opportunistic Infections - epidemiology; AIDS-Related Opportunistic Infections - prevention & control; Anti-HIV Agents - therapeutic use; Bone Diseases, Metabolic - epidemiology; Bone Diseases, Metabolic - prevention & control; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; HIV Infections - complications; HIV Infections - drug therapy; Humans; Risk Factors; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - prevention & control
• ISSN: 1473-6527
• DOI: 10.1097/QCO.0b013e3283460d34

The number of HIV-infected adolescents is increasing dramatically. With combination antiretroviral therapy, they are expected to live well into adulthood. However, complications are emerging at a higher rate in the HIV-infected population compared to the general population. HIV-infected adolescents are also at a high risk of sexually transmitted co-infections. This article reviews the main secondary complications and co-infections in the HIV-infected adolescent. HIV-infected adolescents are at a high risk of sexually transmitted infections. A careful, age-appropriate and developmentally appropriate inquiry into the individual's sexual behavior to assess risk is paramount, in addition to regular screening at medical visits. Treating co-infections is not only important for HIV-infected individuals, but also limits HIV transmission to others. In addition, monitoring and addressing modifiable secondary risk factors for complications such as renal disease, osteopenia or osteoporosis, and cardiovascular disease are critical, well before the onset of clinically apparent disease. Using antiretroviral therapy to suppress viral replication and inflammation appears to be a promising strategy for decreasing secondary complication risk, and likely overshadows the toxicities associated with the long-term use of certain antiretrovirals. Assessing and addressing the risk of secondary complications and co-infections in the HIV-infected adolescent is crucial for optimal length and quality of life.