The Aging HIV Population Is Growing

The Aging HIV Population Is Growing

HIV began mostly as a disease of young men, but today the epidemic impacts people of all ages, including older people (age 50 and over). Issues related to HIV and older people are receiving more and more attention as this population grows. In fact, on September 18, 2009, the first National HIV/AIDS and Aging Awareness Day was held to recognize the need to:

• Prevent HIV infection in this age group
• Understand the unique health effects of the virus in older HIV-positive people
• Improve the health and quality of life of older HIV-positive people
• Increase research on HIV and aging issues

The aging HIV population is growing for two reasons: 1) Powerful HIV drugs are allowing many HIV-positive people to live into their 50s and beyond and 2) While most new HIV infections are in younger people, people 50 and older are also being infected. As a result, about one in four HIV-positive people in the US in 2007 was at least 50 years old. By 2015, nearly half of HIV-positive people in the US will be over 50.

HIV May Speed Up Aging

Many of the health problems of older people appear to happen earlier and progress faster in HIV-positive people. This may be because HIV infection activates (sets off) the immune system and causes inflammation (the body's response to infection). HIV drug treatment reduces immune activation and inflammation, but does not bring back the normal pre-HIV state. On-going inflammation appears to be related to many conditions associated with aging.

Some of the chronic conditions of aging facing HIV-positive people include:

• Cardiovascular disease: As people age, the risk of heart attack or stroke increases. HIV and HIV drugs may further increase the risk.
• Cancers: Having HIV increases the risk of some cancers such as KS, lymphoma, cervical, anal, lung, and skin cancers.
• Bone problems (osteopenia and osteoporosis): Weakened bones can occur with age, especially in women after they stop menstruating. Bone thinning has also been linked to HIV and its treatment.
• Cognitive problems: Mental function, including memory and concentration, tend to decline as people age, but cognitive problems can also be due to HIV infection and some HIV drugs.

HIV-positive people also may be at risk for:

• Liver disease (often related to hepatitis B or C)
• High blood pressure
• Kidney problems
• Metabolic and body shape abnormalities (lipodystrophy)
• Diabetes