September 18 is National HIV/AIDS and Aging Awareness Day

alt

This Wednesday, September 18, is the 6th observance of National HIV/AIDS and Aging Awareness Day (NHAAAD), an occasion to call attention to the epidemic's impact on older people, as well at the aging of people living with HIV in the U.S. According to the U.S. Department of Health and Human Services, approximately 30% of people living with HIV/AIDS are age 50 or older.

A study described in the September 2013 issue of AIDS Care found that this age group accounts for a majority of people diagnosed with AIDS in San Francisco -- one of the early epicenters of the U.S. epidemic.

Since the advent of effective combination antiretroviral therapy in the mid-1990s, many people with HIV are now living into their 50s, 60s, 70s, and even longer. Some research indicates that HIV positive people who receive timely treatment may have a life expectancy similar to that of HIV negative individuals.

But older people with HIV -- especially those who were infected early in the epidemic, reached low CD4 T-cell counts, and used suboptimal treatment with poorly tolerated first-generation antiretroviral -- face some unexpected challenges. These include higher rates of chronic non-AIDS conditions such as cardiovascular disease, neurocognitive impairment, and certain cancers, which appear to occur earlier in this population. Some experts have suggested HIV may have the effect of accelerating aging, perhaps related to persistent immune activation and inflammation.

In a keynote address at this year's International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention in July, Steven Deeks from the University of California at San Francisco, who has done extensive research on aging with HIV and approaches towards a cure, predicted that management of age-related comorbidities will become an increasingly important aspect of HIV medicine worldwide in the coming years. 

"My geriatrician [colleagues] say if you want patients to be playing tennis in their 70s, you need to be dealing with that in their 40s," Deeks said. "I spend my time in the clinic talking about exercise, management of lipids, a Mediterranean diet, and so forth...We should all be helping our patients in their 40s and 50s live to their 70s and 80s, so they're around for a cure."

NHAAAD Resources:

9/17/13

References

KJ O'Keefe, S Scheer, MJ Chen, et al. People fifty years or older now account for the majority of AIDS cases in San Francisco, California, 2010. AIDS Care 25(9):1145-1148. September 2013.

A Rodger, R Lodwick, M Schechter, et al. Mortality in Patients with Well-controlled HIV and High CD4 Counts in the cART Arms of the SMART and ESPRIT Randomized Clinical Trials Compared to the General Population. 19th Conference on Retroviruses and Opportunistic Infections (CROI 2012). Seattle, WA. March 5-8, 2012. Abstract 638.