HIV Patients Live Longer, Face Greater Risks

On Monday, South African health officials told delegates at the 4th International AIDS Society Conference in Sydney that South Africa faces a rise in age-related illnesses among HIV patients as more access antiretrovirals through the government treatment program.

Dr. Brian Gazzard, founder of the British HIV Association, said that as HIV patients age, the virus appears to accelerate several naturally occurring molecular changes, increasing the risks for dementia, osteoporosis, and cardiovascular disease. Ageing and HIV are not a focus of the international research community, and the few studies that have been conducted all focus on the developed world, said Gazzard.

Older patients are rarely included in clinical trials of new HIV treatments, so there are few data on age-specific drug interactions, side effects or interactions with other medicines. Unlike HIV infection in children, there are no guidelines for treating older adults.

Southern African HIV Clinicians' Society President Dr. Francois Venter said older patients frequently have more treatment side effects than young patients. "Treating older patients is much more complicated because they often have underlying kidney or liver disease," he said.

Many South African hospitals have a significant number of older HIV patients in treatment, said Venter. For example, at Johannesburg General Hospital, half the patients are over age 38 and around a fifth are older than age 70, he said. Men comprise a disproportionate number of older HIV patients, said Venter. Data from the Human Sciences Research Council show HIV prevalence among men ages 50-54 was 14.2 percent in 2005, nearly double the 7.5 percent among women.

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