PRN notebook articles
Anogenital human papillomavirus coinfection and associated neoplasia in HIV-positive men and women
Jason Bratcher and Joel Palefsky
The incidence of anal intraepithelial neoplasia (AIN) and anal cancer, caused by human papillomavirus (HPV), is much higher in HIV-positive women and HIV-positive men who have sex with men (MSM) than in the general population, and highly active antiretroviral therapy (HAART) for HIV disease has had little or no impact on this trend. There is a growing need for definitive guidelines to assess for AIN in HIV-positive individuals, and with better treatment options available, it is even more crucial to identify these patients at an earlier stage. New York is the first state to institute recommendations for anal cytology screening in HIV-positive patients.
Selected endocrine topics in HIV: osteoporosis and adrenal insufficiency
Todd T. Brown
The care of HIV-infected patients has become increasingly complex. Endocrine problems, such as osteoporosis and AI, have been frequently reported in the HAART era. Additional considerations may be required regarding the etiologies, diagnosis, and treatment compared with the general population. Further research is required to understand the intricacies of these problems in HIV-infected patients in order to provide optimal care.
The gastrointestinal tract in HIV-1 infection: questions, answers, and more questions!
Saurabh Mehandru, MD
The GI tract is targeted during all stages of HIV disease, and this is especially so during acute and early HIV infection. CD4 cells are preferentially lost from the GI tract within weeks of HIV infection. Despite long-term antiretroviral therapy, CD4+Tcell reconstitution remains deficient in the GI tract in spite of the reconstitution seen in the peripheral blood.