HIV and Disability Updating the Social Security Listings (2010) / Chapter Skim
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2 Current Concepts in HIV/AIDS
2 Current Concepts in HIV/AIDS
Pages 33-44
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From page 33... ...
Furthermore, self-management and adherence to the sometimes complex treatment regimens required by HIV/AIDS represent an ongoing and lifelong challenge for many patients. Finally, the remarkable advances in combination antiretroviral therapy are of little value to those who are unable to access state-of-the-art care, including treatments for conditions associated with HIV infection.
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From page 34... ...
The presence of comorbidities such as major depressive disorder, other mental disorders, or substance abuse may affect neurocognition in HIVpositive individuals. Cognitive limitations may impair many patients and
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From page 35... ...
Common comorbidities among HIV-infected populations with and without neurocognitive disorder include psychiatric and behavioral disorders, which can lead to functional impairment and potential disability. Within psychiatric disorders, major depression, delirium, and anxiety are seen in 25 to 50 percent of individuals living with HIV infection (Pence et al., 2006)
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From page 36... ...
Although this treatment saved lives, its effects were relatively short lived because the virus was able to develop resistance to the single agent. The licensure of ZDV was rapidly followed by the development of a series of additional nucleoside analogues, followed by the introduction of nonnucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, entry inhibitors, and integrase inhibitors.
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From page 37... ...
means that an enormous number of viral variants are produced each day in an infected individual. Although many of these variants are likely to be defective, only a single virus with a mutation conferring resistance to a specific antiretroviral agent can lead to a population of resistant virus.
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From page 38... ...
. Other independent indicators include hemoglobin and direct markers of inflammation and coagulation.
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From page 39... ...
. Nonadherence to combination antiretroviral therapy regimens, which is common among HIV-positive individuals, compromises clinical effectiveness and is an antecedent to the development of viral resistance (Abel and Painter, 2003; Aloisi et al., 2002; Chesney et al., 2000)
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From page 40... ...
Individuals who maintain part- or full-time employment achieve improved physical and mental health due to their improved economic status. Psychological well-being may also improve due to individuals' ability to engage in a standard activity deemed valuable by society (Braveman and Keilhofner, 2006)
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From page 41... ...
However, treatment-related complications and the challenges of managing their health condition may limit full participation in daily activities for some individuals living with HIV/AIDS. Therefore, many individuals remain on Social Security disability despite physical indicators of positive health status such as higher CD4 count, low viral load, or the absence of AIDS-defining illnesses or other infections (Burns et al., 2006)
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From page 42... ...
2009. The combined effect of modern highly active antiretroviral therapy regimens and adherence on mortality over time.
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From page 43... ...
2005. Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence.
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