“
“Tobacco consumption is the modifiable risk factor contributing most

to the development of non-AIDS-defining events among persons living with HIV/AIDS Metformin clinical trial (PLWHA). Clinicians’ awareness of this problem is critical and not yet adequate. Practical information issued by public health authorities or contained in experts’ clinical guidelines regarding how to address smoking cessation in PLWHA is scarce. The aim of this review is to provide physicians with comprehensive and practical information regarding how to identify HIV-positive patients willing to stop smoking and those more likely to succeed, how to choose the most suitable strategy for an individual patient, and how to help see more the patient during the process. In the light of current evidence on the efficacy and benefits of stopping smoking in PLWHA, physicians must actively pursue smoking cessation as a major objective in the clinical care of PLWHA. “
“Distal leg epidermal nerve fibre density (ENFD) is a validated predictor of small unmyelinated nerve fibre

damage and neuropathy risk in HIV infection. As pre-existing damage may increase the risk of neuropathy following antiretroviral (ARV) therapy, particularly when the regimen contains stavudine (d4T), we assessed the relationship between ENFD and various parameters including mitochondrial factors in HIV-infected Thai individuals naïve to ARV therapy. Distal leg and proximal thigh ENFDs were quantified in HIV-infected Thai individuals without neuropathy prior to randomization to a HIV clinical trial Montelukast Sodium that focused on mitochondrial toxicity issues. We assessed their

association with various clinical and immunovirological parameters as well as with peripheral blood mononuclear cell (PBMC) mitochondrial (mt) DNA copies/cell, oxidative phosphorylation (OXPHOS) complex I (CI) and complex IV (CIV) enzyme activities, and mt 8-oxo-deoxyguanine (8-oxo-dG) break frequencies. In 132 subjects, the median (interquartile range) ENFD (fibres/mm) values were 21.0 (16.2–26.6) for the distal leg and 31.7 (26.2–40.0) for the proximal thigh. By linear regression, lower CD4 count (P < 0.01), older age (P < 0.01), increased body mass index (BMI) (P = 0.04), increased height (P = 0.02), and higher PBMC OXPHOS activity as measured by CIV activity (P = 0.02) were associated with lower distal leg ENFD. Older age, increased height, higher BMI, poorer immunological status and higher PBMC OXPHOS activity are associated with lower distal leg ENFD in HIV-infected subjects free of neuropathy prior to initiation of first-time ARV therapy. HIV-associated sensory neuropathy (HIV-SN) is a common neurological complication of HIV infection characterized by bilateral lower extremity burning pain and numbness.