A Haemophilia, HIV and osteoporosis: an emerging problem in clinical practice


ABSTRACT
HIV infection is an important co-morbidity in haemophilia. Some evidences suggest that both these pathologies are related to a reduction in bone mineral density. We describe the complexity in management of a femoral fracture in a patient with severe haemophilia and a long history of treatment for HIV infection.


Articolo presente in – HAART and correlated pathologies n. 14

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Editorial


During own personal life there are many reasons for change. These reasons could be rooted in him/her self, in the environment or in the goal that each person will establish, thanks his/her experiences.
The same is happened to us –I mean to HAART journal.
As you know, we started HAART to cover a space –and Italian scientific journal published in English in order to gather papers and represent a contribution for the spread of the Italian research in HIV/AIDS field. During these years we observed that HIV infection was changing its face. We begun when haart was virtually able to reduce all those pathologies that we were used to consider disease defining AIDS. We started when lay media were keen to tell AIDS stories, we stared when undetectable viral load was undoubtedly considered as a success without any shadows. Now –as says Sharon Levin in her interview published in this issue-“ we know that there have been enormous successes of antiretroviral therapy, huge changes is morbidity and mortality and most people having an undetectable viral load, but almost undoubtedly there is ongoing immune disturbance in people on treatment, diseases of aging, immune activation”. And now we see again many “old” Opportunistic Infections in because of late presenters. As it was claimed by The HIV in Europe Initiative, despite strong evidence that earlier treatment reduces morbidity and mortality, an estimated 50% of the people living with HIV in the EU remain undiagnosed until only late in course of their HIV infection. As they may have almost no symptoms for many years, testing is the only way to achieve early diagnosis, enabling early referral for treatment and care. And we are persuaded that it is because institutions do not speak openly about prevention and because lay press do not cover HIV/AIDS stories. AIDS is thought to be not a problem, at least another plague in Africa, but not still an issue in Europe. Virus do not respect the frontiers. As pointed out by the HIV in Europe Copenhagen 2012 Conference, HIV continues to be an increasing problem in Europe. One major issue is the rapidly expanding HIV epidemic in Eastern Europe. The number of people living with HIV increased by 250% from an estimated 410,000 in 2001 to 1.5 million in 2010, according to UNAIDS. Today, 30 50% of people in Europe living with HIV are unaware of their status and approximately 50% of them present late for care. Entering early into care increases the quality and duration of life of the person living with HIV, it also reduces the risks of transmission.
One of the leading causes of death among people living with HIV is tuberculosis, which internationally is the most frequent co infection striking those people with an impaired immune system. The high mortality rate is also closely related to a growing number of cases of multi‐drug resistant TB and a clear result of late presentation of HIV. And there is also the growing problem of coinfection HIV-HCV, despite the fact that we have now two new direct antiviral agent approved for the treatment of hepatitis C and a impressive, rich pipeline of new molecules hopefully next to come in this therapeutic area. TB, HCV and coinfection are deeply covered in this issue of HAART…
In other word the world of infections is going to be more complex as more complex is going to be the human environment. Being aware of this, we decided to change: to change spaces devoted to reports and interviews form the most relevant international conferences; to change graphics, in order to make easy to read the entire journal and to make easy to find the requested content; to change the paper we use. As an assumption of responsibility, we decided to use paper certified by Forest Stewardship Council, in order to reduce the environmental impact of our journal. The next change, close to be release is our website, that will be an online magazine designed to provide update form all main international conference in our field, video, forums. New opportunities of covering science matters creates new experiences, and because of these new expectation that we should want to fulfill with our engagement. Now we hope that the reason of our changes are clear…

Marco Borderi


Articolo presente in – HAART and correlated pathologies n. 14

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“K Factor” presentation


The “k factor” begins today: a regular column, a new space in HAART journal thought to host interviews -expert opinions- and a synthetic coverage from HIV/AIDS conferences around the world.
When something is going to start, it is important to declare criteria and goals that it is supposed to pursue. We can know only what we can express and say using words: so, let us start from the meanings of the words that we decide to use as title of this column: K and factor.
“K” is the first letter of “key”, the same tool we use every day to open a door, to enter in a room, to access another (may be new) space. As an object, key is a metal instrument shaped so that it will move the bolt of a look: using a key we can lock or unlock something. In music, key is a set of related notes, based on a particular note, and forming the basis -or a part-of a piece of music (for instance, a sonata in the key of E flat major). In a figurative meaning, key could be: a set of anwers to exercises or problems; the explanation of the symbol used in a coded message or in a map. Key is also “something” that provides access, control and understanding.
The word factor means the whole of circumstances that help to produce a result or could influence a decision or a choice.
Close to the 30th year of AIDS epidemic, we think it could be clear the reason why we decided to title these pages “k factor”.


Articolo presente in – HAART and correlated pathologies n. 9

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From bone to heart


ABSTRACT
To investigate the relationship between bone mineral density and cardiovascular disease, between aortic calcification, bone mineral density and fractures, and between vitamin D deficiency and risk of cardiovascular disease; describe the mortality rate after all types of osteoporotic fracture, and speculate about the role of osteoclast-like cells in arterial calcification.
Keywords: Bone mineral density; Cardiovascular disease; Fracture; Vitamin D.


Articolo presente in – HAART and correlated pathologies n. 5

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