Is HIV Disease Different for Older People?

Is HIV Disease Different for Older People?

The first studies of HIV in older people were done before strong anti-HIV drugs were available. Most of them showed that older people got sicker and died faster than younger people. This was thought to be due to the weaker immune systems of older people. Also, older people usually have health problems in addition to HIV.

Recent research shows that older people respond well to antiretroviral treatment. Most older patients, unless they are drug users or have mental problems, take their medications more regularly than younger patients. They have better adherence (see Fact Sheet 405).

Is HIV the Same in Older People?

CD4 cell levels do not recover as quickly in older patients as in younger patients. Unfortunately, we don't have good information on older people because they were usually not included in clinical trials of new drugs.

Treatment side effects may not be any more frequent in older people. However, changes caused by aging can resemble or worsen treatment side effects. For example, aging is a major risk factor for heart disease and for increasing fat in the abdomen. Some older people without HIV lose fat that looks similar to the changes caused by lipodystrophy.

Recent research suggests that many of the health problems of older people may progress faster in people with HIV. It is not clear whether HIV "accelerates" aging or whether the normal diseases of aging interact with each other and HIV and make them worse.