Comorbid diseases and conditions in people with HIV in the UK.

OBJECTIVES: This study aimed to characterize the risk of people living with HIV (PLHIV) in the UK progressing to pre-specified HIV-associated comorbidities, compared with matched, HIV-negative controls. METHODS: Primary and secondary care records from the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) were used to identify PLHIV, and a matched cohort from the HIV-negative population. Kaplan Meier curves and Cox proportional hazard models were used to evaluate the risk of developing comorbidities including central nervous system (CNS) disorders, end-stage renal disease, osteoporosis, diabetes, cardiovascular disease (CVD), hypertension, stroke and cancer. RESULTS: A total of 2945 PLHIV were matched to a cohort of 5890 HIV-negative controls. PLHIV demonstrated an increased hazard ratio (HR) for time to development of incident sleep disorders, depression, osteoporosis, stroke, cancer and renal disease when compared with their matched HIV-negative control. The HRs for anxiety, hypertension, diabetes and CVD were not significantly increased. CONCLUSIONS: PLHIV in the UK were at a higher risk of developing a number of comorbid conditions, highlighting the need for regular attendance of health reviews such as the annual health reviews recommended by the British HIV Associations (BHIVA) quality standard for care, which are currently not uniformly conducted.

Biogenesis, Stabilization, and Transport of microRNAs in Kidney Health and Disease.

The kidneys play key roles in the maintenance of homeostasis, including fluid balance, blood filtration, erythropoiesis and hormone production. Disease-driven perturbation of renal function therefore has profound pathological effects, and chronic kidney disease is a leading cause of morbidity and mortality worldwide. Successive annual increases in global chronic kidney disease patient numbers in part reflect upward trends for predisposing factors, including diabetes, obesity, hypertension, cardiovascular disease and population age. Each kidney typically possesses more than one million functional units called nephrons, and each nephron is divided into several discrete domains with distinct cellular and functional characteristics. A number of recent analyses have suggested that signaling between these nephron regions may be mediated by microRNAs. For this to be the case, several conditions must be fulfilled: (i) microRNAs must be released by upstream cells into the ultrafiltrate; (ii) these microRNAs must be packaged protectively to reach downstream cells intact; (iii) these packaged microRNAs must be taken up by downstream recipient cells without functional inhibition. This review will examine the evidence for each of these hypotheses and discuss the possibility that this signaling process might mediate pathological effects.