For instance, in many HIV-infected cohorts, cigarette smoking, re

For instance, in many HIV-infected cohorts, cigarette smoking, recreational drug use (including cocaine use), increased alcohol intake and reduced physical activity are highly prevalent [11]. These factors may also affect the risk of neurocognitive disorders (HIV-associated neurocognitive disease and dementia), non-AIDS-associated

malignancies, liver disease, diabetes, and renal and osteoporotic bone diseases. Some Tyrosine Kinase Inhibitor Library cost cohort studies have already suggested that modification of risk factors can decrease the incidence of non-AIDS-defining chronic conditions, including CVD [6]. Hence, it is important to screen and manage risk factors for long-term age-related diseases that increasingly affect the HIV-infected population. Most studies that have examined the contribution of HIV infection to mortality, including those discussed above, do not have an ideal control population. Hence, considerable caution needs to be exercised when attributing relative risk of mortality caused by HIV itself as opposed to unattributed associated confounding variables, particularly lifestyle factors. Even a supposedly ideal control population, such as individuals at high risk of HIV infection but who remain uninfected, might differ in terms of host

factors that govern both infectability and mortality. A study from Denmark that carefully matched cases and controls concluded that mortality in patients without risk factors on successful Protein Tyrosine Kinase inhibitor HAART therapy is almost identical to that of the non-HIV-infected population [12]. It is important to further define the relationship between HIV infection and mortality, especially those factors that can be modified to attenuate any risk. Screening tools and risk calculators for the general population have been developed for some common noncommunicable chronic diseases, as best exemplified

by coronary heart disease (CHD), fragility fractures, diabetes and renal disease. Personalized risk prediction aims to estimate, communicate and monitor risk to motivate adherence to lifestyle change or therapies, and to allocate scarce prevention dipyridamole resources and strategies appropriately. The World Health Organization (WHO) has recently focused on noncommunicable diseases (NCDs), as they are the leading cause of death globally, killing more people each year than all other causes combined [13]. The WHO has recognized that, contrary to popular opinion, available data demonstrate that nearly 80% of NCD deaths occur in low- and middle-income countries [13]. CVD is one of the leading causes of death in the UK and is largely preventable [14]. In 2008, there were more than 191 000 deaths attributable to heart and circulatory disease in the UK, including 88 000 deaths from CHD and a further 43 000 from stroke.

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