Secondary Conditions and Costs
People with metabolic and immunological abnormalities such as lipodystrophy or dyslipidaemia more likely to develop and/or are predisposed to Type 2 diabetes mellitus (T2DM) and cardiovascular disease.
Cardiovascular disease has emerged as a leading cause of non-AIDS death. Studies have found that cardiovascular disease affects people who are HIV-positive more often than HIV-negative comparison groups.
The prevalence of cardiac abnormalities in adults with HIV and AIDS has been reported to range between 28% and 73%. Cardiomyopathies are also associated with HIV-infection.
Studies show a higher prevalence of diabetes in people who are HIV-positive; predominantly women. HIV and two types of antiretrovirals--nucleosides and protease inhibitors--may contribute to the risk of diabetes. Earlier studies found poor blood sugar control in people with diabetes and HIV.
Studies show that the use of HIV Protease inhibitors has been associated with hyperlipidemia and dyslipidemia, an abnormal amount of lipids (e.g. cholesterol and/or fat) in the blood. The conditions are more common and more severe than what was observed before the advent of HAART. Hypertriglyceridemia (where cholesterol and/or triglyceride levels are elevated) is also found and is caused and/or exacerbated by uncontrolled diabetes mellitus, obesity, and/or sedentary lifestyle habits.
People with HIV have been found to have greater prevalence of reduced bone mineral density.
A CDC study which compared data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES) showed that obesity (body mass index above 30 kg) affected 35.7 percent of NHANES participants and 22.8 percent of people with HIV.
Age-adjusted prevalence for obesity in HIV-positive women exceeded the general population rate (40% versus 36%). Men who were HIV–positive had an obesity rate less than half that of general-population of men (17% versus 36%).
About half of the women who were HIV-positive under the age of 40; a total of 45 percent were obese.
Studies have shown that people of all ages infected with HIV have abnormally low levels of cardiorespiratory fitness (CRF). These low levels of cardiorespiratory fitness have been attributed to sedentary behavior or sedentary lifestyle habits. Further, people with HIV often exhibit a maximal VO2 of 24 percent to 44 percent below their age-predicted normal values.
Recent studies also suggest that people with HIV have a higher risk of experiencing earlier onset of aging and fragility. Signs of fragility include: low endurance, poor strength, impaired balance, and low levels of physical activity.
Despite advances in treatment, there is no cure for HIV/AIDS. The treatment costs of HIV and AIDS is immense. Current research demonstrates that overall treatment costs for HIV and AIDS are increasing as HAART costs increase. Research also shows that hospitalization costs while first decreasing over the last two decades, now appear to be rising again. For detailed cost analysis and information see:
Farnham, Paul G. "Do Reduced Inpatient Costs Associated with Highly Active Antiretroviral Therapy (HAART) Balance the Overall Cost for HIV Treatment?" Applied Health Economics and Health Policy. Springer Science & Business Media. 2010.
The analysis used multiple datasets and sources.