August 25, 2016
The widespread availability of potent anti-HIV therapy (commonly called ART) in Canada and other high-income countries has had a tremendous impact on the health of HIV-positive people. Many ART users have had an increase in their life expectancy. The power of ART is so profound that researchers increasingly expect that a young adult who becomes HIV positive today and who initiates ART shortly thereafter and who takes ART every day and receives regular monitoring and checkups and who does not have other pre-existing serious health complications should have a near-normal lifespan.
Independently of HIV, aging is associated with the development of an increased risk for other health conditions as key organs and systems gradually degrade. According to a team of U.S. researchers who have reviewed scientific publications about aging and HIV, there are reports that some HIV-positive people experience an earlier onset of age-related health issues or may experience them in a more severe form than HIV-negative people do. The same researchers note that although there are more and more studies that assess the health of HIV-positive people over the age of 50, relatively few seek to address the health of the subset of HIV-positive people aged 65 and older.
To begin to address this issue, the researchers reviewed and compared diagnoses of selected co-existing health conditions (called comorbidities) in a massive population of older people. Their study involved reviewing health information of people aged 65 and older that was collected in a database. They found that HIV-positive people were significantly more likely to have certain chronic health conditions compared to HIV-negative people.
At a minimum, these findings suggest that clinics and health systems will have to prepare for the complexities of caring for more HIV-positive people who have chronic conditions as they age. This may mean that health policy planners will have to ensure that more funds are available for caring for elderly HIV-positive people.
Researchers analysed a database containing health-related information from people who had made use of the American health insurance program called Medicare. This program is primarily used by people who are 65 and older. The data were collected between 2006 and 2009. Researchers compared data collected from Medicare recipients who were distributed as follows:
On average, HIV-positive participants were more likely to be people of colour and male and somewhat younger (71 years) than HIV-negative people (75 years).
HIV-positive people were significantly more likely to have been diagnosed with the following chronic health conditions:
Furthermore, researchers found that, in general, more HIV-positive people were likely to have been diagnosed with all five of these comorbid conditions than HIV-negative people.
The findings from this study are a good first step in identifying some of the health issues faced by people aged 65 and older. Hopefully this study will spur additional research into the health care needs of older HIV-positive people.
"America's other drug problem: Giving the elderly too many prescriptions" -- Washington Post
Emerging issues in older HIV-positive people -- TreatmentUpdate 214
Denmark -- unexpected trends in use of psychotropic medicines -- TreatmentUpdate 204
Quantification of biological aging in young adults -- Proceedings of the National Academy of Science USA
Management of Human Immunodeficiency Virus Infection in Advanced Age -- Journal of the American Medical Association
Dutch doctors explore intersection of aging and HIV -- CATIE News
The CIHR Comorbidity Agenda -- Canadian Institutes of Health Research (CIHR)
HIV and aging -- Healthy living tips for people 50 and over living with HIV
Mental Health -- HIV in Canada: A primer for service providers
HIV and brain-related issues -- TreatmentUpdate 204
Longer life expectancy for HIV-positive people in North America -- TreatmentUpdate 200
Factsheets on HIV and aging in Canada -- Canadian AIDS Society
HIV & Aging: A 2013 Environmental Scan of Programs and Services in Canada -- Community Report -- Canadian Working Group on HIV and Rehabilitation (CWGHR)
|Higher Rates of Five Major Non-AIDS Comorbidities After Age 50|
|Earlier Start of Antiretroviral Therapy Impacts Aging With HIV (Video)|
|Emerging Issues in Older HIV-Positive People|
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