It is now 30 years since the first cases of acquired immunodeficiency disease syndrome (AIDS) were reported in the United States. Major breakthroughs have been accomplished since then: for example, the discovery of the human immunodeficiency virus (HIV) in 1983 as the etiological agent; the approval of zidovudine as the first antiretroviral drug in 1987; and the introduction of triple combination therapy in 1996. Following implementation of highly active antiretroviral therapy (HAART), sustained suppression of viral replication and CD4 count restoration are achieved by most HIV-infected individuals. As a result, life expectancy of HIV-infected persons is approaching that of the general population. In contrast, comorbidities such as cardiovascular disease and liver complications have replaced opportunistic infections and cancers as a cause of hospitalization and death in this population. Clearly, a new face of HIV disease in an aging population has emerged, with challenges that merit new consideration and management.
This first issue of Hot Topics in HIV and Other Retroviruses is completely devoted to metabolic complications and cardiovascular risk in HIV. The three chapters discuss several aspects from the role of HIV infection itself, to the contribution of some antiretroviral medications. I trust it will help HIV physicians in the decision-making process while attending patients with HIV infection.