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ComplicationsofHIVInfection:ASystemsBasedApproach

Table1.
ComplicationsinPatientswithHIV/AIDS

DIRECT
COMMON ASSOCIATED ANTIRETROVIRALTREATMENT
SYSTEM EFFECTOFHIV
COMPLICATIONS PATHOGENS RELATEDADVERSEEFFECTS
INFECTION

Neuropsychiatric HIVassociated Primarycentral Cryptococcus Efavirenz(Sustiva):vivid

(Table3) neurocognitive nervoussystem neoformans, dreams,sedation
disorders, lymphoma CMV,JCvirus,
NRTIs:peripheralneuropathy
neuropathy, Toxoplasma
radiculopathy, Chronic gondii
myelopathy psychiatric
disorders

Headandneck HIVassociated Gingivitis,dental Retinitis:CMV,T.gondii

retinopathy andsalivary
Acuteretinalnecrosisand
glanddisease
progressiveouterretinal
necrosis:HSV,varicellazoster
virus

Otitis,sinusitis:invasivefungi

Cardiovascular HIVassociated Cardiovascular Myocarditis, Abacavir(Ziagen):

cardiomyopathy disease, pericarditis: cardiotoxicity*
endocarditis CMV,invasive
Proteaseinhibitors:
fungi,
dyslipidemia
Mycobacterium
Atherosclerosis species,T.
gondii

Pulmonary HIVassociated Chronic Pneumonia,

pulmonary obstructive pneumonitis:
hypertension pulmonary CMV,invasive
disease,lung fungi,
cancer(including Pneumocystis
Kaposisarcoma jiroveci
andlymphoma) (formerly
Pneumocystis
carinii),T.
gondii

Pulmonary
Emphysema*
tuberculosis:
Mycobacterium
tuberculosis

Gastrointestinal HIVinduced Viralhepatitis, Candida NRTIs:pancreatitis

(Table4) enteropathy lymphoma, species,CMV,
Proteaseinhibitors:diarrhea,
Kaposisarcoma, HSV,protozoa
fattyliver*

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HPVrelated
DIRECT
COMMON
malignancies ASSOCIATED ANTIRETROVIRALTREATMENT
SYSTEM EFFECTOFHIV
COMPLICATIONS PATHOGENS RELATEDADVERSEEFFECTS
INFECTION

Nonalcoholic
fattyliver
disease*

Renal/genitourinary HIVassociated Chronickidney Sexually Proteaseinhibitors:

nephropathy diseasenot transmitted nephrolithiasis
causedbyHIV infections(e.g.,
Tenofovir(Viread):
associated Chlamydia
nephrotoxicity
nephropathy trachomatis)

Endocrine Impairedlipid Adrenalgland Proteaseinhibitors:lipidor

andglucose infiltration: glucosedisorders,
metabolism CMV,invasive lipodystrophy
fungi,
HIVassociated Mycobacterium
wasting species

Lipodystrophy

Hypogonadism,*
premature
ovarianfailure

Musculoskeletal Myopathy, Osteopenia, NRTIorNNRTIs:

myositis osteoporosis, osteomalacia*
osteonecrosis
Proteaseinhibitorswith
statins:myopathy

Hematologicor Anemiaof Lymphoma, Bonemarrow Zidovudine(Retrovir)and

oncologic chronicdisease multiplemyeloma infiltration trimethoprim/sulfamethoxazole
(leadingto (Bactrim,Septra):anemia
pancytopenia):
CMV,invasive
Coagulation fungi,
disorders* Mycobacterium
species

Dermatologic Eosinophilic Papulosquamous Fungal

folliculitis* disorders(e.g., dermatoses,
eczema, varicellazoster
seborrheic virus
dermatitis,
psoriasis)
molluscum
contagiosum
Kaposisarcoma

CMV=cytomegalovirusHIV=humanimmunodeficiencyvirusHPV=humanpapillomavirusHSV=herpessimplexvirusNNRTI
=nonnucleosidereversetranscriptaseinhibitorNRTI=nucleosidereversetranscriptaseinhibitor.

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*Researchsuggestsanassociation,butevidenceisnotdefinitive.

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