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predisposition and hiv
May 29, 2003

Hi

Does hiv status increase liklihood that I will come down with disease(s) for which I have a genetic predisposition? For example, if my g-father died of colon cancer and i have that gene, is it somewhat more likely that I will develop colon cancer earlier in life due to the breakdown in my immune system? What about fact that my parenmts both have heart disease? Another related question is will hiv make me old before my time? Kevin

Response from Dr. Young

In general, HIV status doesn't directly affect one's risk for coming down with a hereditary disease, or one with a genetic predisposition.

There might be some exceptions, like colon cancer-- there seems to be an increased risk of certain types of cancer among otherwise healthy persons with HIV infection. It is tempting to speculate that this risk, coupled to a possible hereditary risk might cause a doubly negative situation with even greater risk.

Understand, though that this is a theoretical statement and I'm not aware that this has been observed, or explained by our epidemiologists (who spend inordinate amounts of time looking for unexplained relationships between things).

On a more practical note, if you indeed have a family history of colon cancer, then I'd be more vigilant about having cancer screening tests (like fecal occult blood, digital rectal exams, etc) in order to not miss any early warning signs.

The same is true for heart disease, since there are conflicting reports and concern about increased risk of heart disease among persons with HIV infection. Again, this does not mean that it WILL happen, but that taking prudent steps to avoid excess risk would be reasonable. What does this mean? Not smoking is probably the most important; diet, exercise, blood pressure managment also all play important roles in heart disease prevention. BY


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