STUDYING ENDOCRINE GLAND DYSFUNCTION IN HIV-INFECTED PATIENTS TO IMPROVE THEIR HEALTH, QUALITY OF LIFE, AND LIFE EXPECTANCY (Literature Review)
DOI:
https://doi.org/10.52914/apmp.v7i2.85Keywords:
human immunodeficiency virus, hormones, endocrine glands, treatment, metabolism, adrenal insufficiency, doctor, patient, medicineAbstract
This article examines current issues regarding endocrine disorders in people living with human immunodeficiency virus (HIV), focusing on the impact of HIV infection and antiretroviral therapy on the functional status of endocrine glands, bone metabolism, and body composition. It outlines the current epidemiological situation concerning the prevalence of HIV globally and in Ukraine, challenges in accessing life-saving treatment, and the importance of the timely detection of comorbid pathological conditions.
The article analyzes the characteristics of adrenal dysfunction in patients with HIV, specifically the potential impact of protease inhibitors – including ritonavir – on the metabolism of inhaled and injectable glucocorticoids. It discusses the prevalence of hypogonadism and the specifics of its hormonal diagnosis (considering sex hormone-binding globulin levels), as well as disturbances in bone metabolism, vitamin D deficiency, and an increased risk of fractures. Particular attention is given to distinguishing between HIV-associated wasting (accompanied by sarcopenia) and lipodystrophy syndrome, as well as the potential use of hormone therapy based on appropriate clinical indications.
The necessity of a comprehensive, interdisciplinary approach to the diagnosis, prevention, and management of endocrine and metabolic disorders in people living with HIV is substantiated. Promising areas include conducting further international and interdisciplinary research, refining evidence-based pharmacotherapy, evaluating the efficacy, safety, and pharmacoeconomic viability of medicinal products, as well as implementing telemedicine, telepharmacy, and artificial intelligence technologies. Emphasis is placed on the importance of medical and pharmaceutical law, interprofessional collaboration, and the integration of research findings into the training of medical and pharmaceutical professionals and into clinical practice.
It is concluded that the timely detection of endocrine disorders, proper monitoring of hormonal and metabolic parameters, and the individualization of pharmacotherapy are essential for preventing complications, enhancing treatment efficacy, and improving the quality of life for people living with HIV.
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