First, a more complex spectrum of treatment changes among women, driven by more symptoms/side effects attributed to ART. Second, less intake of protease inhibitors among women, potentially mitigating or reversing treatment-associated lipodystrophy and metabolic complications by omitting these components of ART [27]. Third, the disproportionate http://www.selleckchem.com/products/Erlotinib-Hydrochloride.html prevalence of renal dysfunction among men, possibly reflecting a higher exposure to toxicities of ART [28] (in our study, men were taking ART on average 18 months longer than women). Finally, since in the German population women are known to report a higher frequency and severity of symptoms [29], we expected to have similar findings in the population of people with HIV.

However, in our study women and men with HIV did not differ on the frequency and severity of symptoms, which also may indicate that women were more successful in reducing side effects of ART. Sharing lab results -gaps in physician-patient communication? Another imperative discovery of our study was the incongruence between physicians’ and patients’ reports of laboratory abnormalities. Only one of seven participants indicated potentially ART-related laboratory abnormalities that were documented in the physician’s records. This might partially be explained by attribution of laboratory abnormalities to other causes, such as co-infection with viral hepatitis. Some laboratory abnormalities may simply be not avoidable, such as lipid and glucose elevations in patients with a predisposition to develop a metabolic syndrome, or elevated liver enzymes in patients with a hepatitis co-infection.

Clinical significance of laboratory abnormalities depends on the treatment, the treatment experience, and the patient’s vulnerability to develop certain side effects. Since the majority of the laboratory abnormalities were mild, physicians may not have discussed them with their patients or patients did not recall the discussion. A patient’s forgetfulness of laboratory abnormalities may indicate that his/her focus is on benefit rather than on risk of the treatment, weighing long survival with HIV against laboratory alterations such as elevated lipids, liver enzymes, or lactic acidosis. By focusing on HIV, some patients may ignore their individual risk of cardiovascular or liver disease.

Thus, Drug_discovery a patient’s “selective memory” may serve as an individual strategy to cope with the disease and its treatment and to avoid panic about minor laboratory alterations. Nevertheless, in the context of ART, abnormalities of liver enzymes, even if they are mild, require further examination of the etiology and may be an indicator of ART-related mitochondrial injury and hepatic steatosis [30,31]. Since potentially ART-related laboratory abnormalities might be amenable to change by treatment modifications, the lack of patients’ awareness of these abnormalities should be addressed.