HIV and Aging
Thanks to advances in treatment, people with HIV are living much longer than ever before. It is estimated that up to 12 per cent of HIV-positive people in Canada are 50 years of age or older. This number is expected to increase by as much as 20 per cent over the next decade. Unfortunately, the number of people 50 or older who are newly diagnosed with HIV is also growing.
Early diagnosis of HIV is important no matter what your age; however, the older you are, the more critical early diagnosis becomes. This is because HIV progresses more quickly in older people. The good news is that anti-HIV drugs appear to work just as well whether you are 52 or 25 years old. And studies show that age and better control of HIV seem to go hand in hand. If you are HIV-positive later in life, you are more likely to achieve and maintain an undetectable viral load than younger people with HIV, maybe because you are better at following treatment instructions. (An undetectable viral load means that the amount of HIV in your blood is so low that it cannot be detected by tests.)
Treating HIV can become more complicated as we get older. This is because the chances of having other health problems that also require treatment, such as high blood pressure, arthritis or even cancer, also increase with age. Taking several drugs at the same time can raise your risk of drug interactions, side effects and toxicities. This is why it is especially important to carefully monitor the medications you are taking.
The side effects of anti-HIV drugs don't appear to affect people more as they get older, but they can be made worse by the side effects of other non-HIV drugs. Decreases in kidney and liver function that come naturally with age, changes in hormone levels and metabolism, as well as weight loss associated with aging can all increase the chance of an adverse drug reaction. Make sure your doctor is aware of any conditions you may have and all the medications and supplements you are taking. This will allow you and your doctor to work together to keep your HIV under control and manage any side effects from your medications.
Many of the health changes that occur with aging can be similar to the symptoms of HIV as well as to the side effects of HIV treatment. Let's take a look at some of the health conditions associated with both age and HIV.
Changes to the Immune System
As you age, your immune system becomes less effective at protecting your body from infection and disease. This is why HIV can progress more quickly in people who are older and why early diagnosis of HIV is so important. HIV also weakens your immune system. Because your immune system is your body's system for fighting off germs, a weakened immune system can make you more susceptible to infections and illnesses. HIV treatment can help strengthen your immune system, so that it is better able to fight off germs and keep you healthy.
Heart disease is a broad term that includes coronary heart disease, heart attack, stroke and other conditions that affect the heart and blood vessels. It is also sometimes called cardiovascular disease.
As you age, the risk of developing heart disease increases, whether you are HIV-positive or not. Women older than 55 and men older than 45 are at higher risk of developing heart disease. If a member of your family -- your father, your mother, an uncle, an aunt or a sibling, for instance -- has heart disease, your risk of developing heart disease is higher than that of a person who does not have a family history.
While you can't control some risk factors for heart disease, such as your age and family history, there are many risk factors you can control. These include smoking, being overweight, lack of exercise, poor diet, excessive alcohol intake, high levels of cholesterol in your blood, diabetes and high blood pressure (or hypertension).
The relationship between HIV and heart problems is not fully understood but is being studied. Some studies show that certain anti-HIV drugs, such as some protease inhibitors, may increase the risk of heart problems by raising the level of cholesterol and triglycerides in your blood. Other research suggests it may be HIV itself that causes heart problems. In either case, it is clear that the benefits of HIV treatment far outweigh the risks of heart disease.
Healthy Heart Habits
You can lower your risk for heart problems by making the following lifestyle changes:
Your doctor should monitor your cholesterol levels and your blood pressure. If either is elevated, you may want to consider treatment.
This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
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