In the early stages of the HIV epidemic, AIDS-defining illnesses (ADIs) were the most significant health concerns for people living with HIV. ADIs included opportunistic infections and cancers that typically only occurred in people with severely weakened immune systems due to HIV. However, highly effective antiretroviral therapy (ART) has allowed people with HIV to live longer and healthier lives, resulting in fewer ADIs. Instead, non-AIDS-defining diseases (NADs) are becoming more prevalent as people with HIV age. NADs are medical conditions that occur in people living with HIV but are not directly caused by the HIV. These diseases can include a wide range of health issues, such as cardiovascular disease, cancer, liver disease, kidney disease, neurological disorders, and even mental health conditions.

People living with HIV (PLWH) are at a higher risk of developing NADs due to various factors such as age, lifestyle, comorbidities, and HIV-related immune dysfunction. Previous studies show that the prevalence of CVD in people with HIV was estimated to be around 9%, compared to 5% in the general population. In people with HIV and hepatitis C virus (HCV) co-infection, the prevalence of advanced liver disease (defined as cirrhosis or liver cancer) was around 15-30%, compared to 2-4% in people with HCV alone. These NADs significantly impact the quality of life of PLWH and pose challenges in their management. Therefore, a comprehensive approach that considers both the HIV infection and the specific NAD is necessary for managing NADs in PLWH. This approach may involve intensive monitoring, lifestyle modifications, and the use of specialized medical treatments. It is essential for PLWH to work closely with their healthcare providers to manage both their HIV infection and any NADs they may develop.

The Research Topic will focus on NADs that have a high prevalence or incidence rate in PLWH, such as cardiovascular diseases, renal diseases, liver diseases, neurological diseases, cancer, and mental health disorders. The contributors will explore the epidemiology, pathophysiology, risk factors, diagnosis, treatment, and management of these NADs in PLWH. We welcome Original Research articles, Review articles, and Perspectives related to NADs in PLWH. Potential topics include but are not limited to the following:
● Epidemiology and burden of NADs in PLWH
1. Prevalence and incidence of NADs in PLWH, including specific NADs of interest
2. Demographic and clinical factors that may influence the prevalence and incidence of NADs in PLWH
3. Comparison of NAD prevalence and incidence in PLWH vs. the general population
4. Measures of burden of NADs in PLWH, such as DALYs, healthcare utilization, costs, and quality of life
5. Implications of NAD burden for PLWH and healthcare systems, including challenges and opportunities for prevention and management.
● Pathophysiology and mechanisms of NADs in PLWH
1. HIV-associated inflammation and immune dysfunction;
2. ART-related toxicity;
3. Interactions between HIV infection, ART, and other risk factors;
4. Mechanisms specific to individual NADs: The pathophysiology of individual NADs may vary depending on the specific disease in question. For example, the mechanisms underlying cardiovascular disease in PLWH may involve a combination of inflammation, ART toxicity, and traditional risk factors, while the mechanisms underlying kidney disease may involve direct HIV-associated kidney damage.
● Risk factors associated with NADs in PLWH
● Diagnosis and screening of NADs in PLWH – including clinical evaluation, laboratory test index and imaging examinations, etc.
● Management and treatment of NADs in PLWH
● Mental health disorders in PLWH with NADs
● Cardiovascular diseases in PLWH
● Renal diseases in PLWH
● Liver diseases in PLWH
● Neurological diseases in PLWH
● Cancer in PLWH
● Long-term prognosis and survival of PLWH with NADs – including mortality, prognostic factors, quality of life, coordinated care

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