Grant: CIHR Fellowship

Many persons who live with HIV are affected by other health problems. Liver diseases have even become one of the most frequent causes of death among HIV-infected persons. In order to survive their HIV infection, they have to take anti-HIV drugs throughout their life, some of which appear to be harmful for the liver. A great proportion of HIV-infected persons also suffer from chronic pain. This pain and its treatment can influence encounters with the healthcare system and their HIV control. The two aims of this project are: 1) to understand which HIV treatments might harm the liver; and 2) to study the relationship between chronic pain and treatment adherence and HIV control. I will be using data from close to 30,000 HIV-infected persons in the United States. First, I will outline the state of liver health in persons living with HIV in the United States by describing the types of liver problems they have experienced. I will use advanced statistical methods to determine which combinations of HIV drugs affect the liver. Second, I will describe levels of chronic pain over time and compare treatment adherence and HIV control according to whether HIV patients were treated for their chronic pain or not. The results of this research are expected to contribute to the improvement of North American HIV treatment guidelines. Physicians will be able to use the conclusions of this project to decide which treatment to prescribe in order to help prevent the development of potentially severe liver problems, as well as to develop strategies to help patients with chronic pain to remain engaged in care and to have better control over their infection.