Project Inform Forum Focuses on HIV and Aging

Effective antiretroviral therapy has helped make age-related concerns come into focus among HIV patients and health care providers. About 15 percent of newly HIV-infected people are over age 50, and by 2015 nearly half of HIV-positive people in the United States will be over 50. The proportion is already 40 percent in San Francisco, where Project Inform sponsored a recent forum on aging and HIV.

"For the last 10 years we've been so excited about therapy helping people live longer that we've gotten a bit selfish," said Dr. Steven Deeks of San Francisco General Hospital. "We now want people to live a normal lifespan with completely restored health, but we're not there yet."

Even effectively treated, HIV infection can persistently activate the immune system and ignite widespread inflammation. Antiretrovirals reduce this but cannot bring back the pre-infected state. Chronic low-grade inflammation in long-term HIV survivors appears to underlie many conditions associated with aging, Deeks said.

More research is focusing on these age-related conditions, which seem accelerated among some younger patients. The chronic conditions include cardiovascular disease, kidney impairment, non-AIDS cancers, osteoporosis, cognitive decline and frailty, said Matt Sharp, Project Inform's director of treatment and prevention advocacy.

HIV-positive people can prevent some diseases by quitting smoking, eating a healthy diet, getting more exercise, and ending or reducing their use of alcohol and recreational drugs. "You don't need to join a gym to exercise, you just need to get your blood moving for 30 minutes a day," Sharp said. Anal Pap smears, colon cancer tests, and cholesterol screenings are also important, he added.