The risk of illness and death is greater for the HIV-infected than for the general population, particularly if antiretroviral therapy (ART) is deferred.1 Immune factors, health-related behaviors, and drug toxicity can contribute to this risk.1


  • Cardiovascular disease
  • Many non-AIDS cancers
  • Non-AIDS infections
  • Chronic obstructive pulmonary disease
  • Osteoporosis
  • Type II diabetes
  • Thromboembolic disease
  • Liver disease
  • Renal disease
  • Neurocognitive dysfunction
  • Frailty

The goal when selecting initial therapy is to provide the most potent and safe regimen possible that the patient can tolerate and adhere to. Certain comorbidities are of particular consideration1:

  • Cardiovascular disease; hyperlipidemia; renal disease; osteopenia/osteoporosis (or conditions associated with bone mineral density loss); psychiatric illness; neurologic disease; drug abuse/dependency requiring substitution therapy

Additionally, medications that treat comorbidities can contribute to potential drug-drug interactions with ART, and may lead to increased or decreased drug exposure.1