Comorbidities and Complications
There are few more heated topics among frontline HIV care providers than the concept of "premature aging" among individuals living with the virus. As the ever-increasing efficacy and tolerability of antiretroviral therapy reduces mortality rates and increases lifespans, the impact of HIV -- and the medications we use to treat it -- on senescence will inevitably gain more attention. In fact, the number of studies in 2012 that touched on the issue is staggering, and is bound to increase further as we move into 2013 and beyond.
And yet, when it comes to the intersection of aging and HIV, we still have far more questions than answers. In a captivating presentation at CROI 2012, Amy Justice, M.D., Ph.D., questioned some of the fundamental conclusions that many in the research community have reached on the subject in recent years. Although "there certainly is more of a trend for HIV-positive people to be a bit younger" when they develop certain health problems, as Justice said in a recent interview, "we're talking about somewhere between one and six years -- we're not talking about 20 or 30 years," which is what earlier research seemed to suggest.
We are still only gazing out at the sunrise when it comes to gaining a better understanding for how HIV and antiretrovirals impact the rate and severity of complications we commonly think of as related to aging -- cardiovascular disease, bone fractures, cirrhosis, renal failure, lung cancer and so forth. Presentations such as Justice's point to the importance of keeping a level head and a reasonable approach when discussing with HIV-infected patients and clients the risks and realities of aging with HIV.