Aging and HIV
October 2, 2014
Table of Contents
Worldwide, more than three and a half million people 50 years and older are living with HIV (HIV+). According to UNAIDS, the proportion of HIV+ older adults continues to increase in all regions. For the first time since the HIV pandemic began, one in ten HIV+ adults is 50 or over in low- and middle-income countries.
In the US, 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). While 50 may not seem 'old,' it is often the age currently used by organizations that keep track of health-related statistics (e.g., the US Centers for Disease Control and Prevention, or CDC). The CDC estimates that half of all HIV+ people in the US will be 50 and over by 2015. As a result, issues related to getting and being older with HIV are receiving more and more attention as this population grows.
The aging HIV+ population is growing for two reasons: 1) powerful HIV drugs are allowing many HIV+ people to live into their 50s and beyond; and 2) while most new HIV infections occur in younger people, people 50 and older are being infected at increasing rates. As a result, while only one in four HIV+ people in the US was at least 50 years old in 2007, that number is expected to double by 2015.
Many of the medical problems facing HIV+ people now have more to do with diseases of aging than HIV-related illnesses. More middle-age and older HIV+ people are experiencing medical problems related to aging. Research shows that almost two-thirds of deaths among HIV+ people are currently the result of non-AIDS-related causes.
Recent advancements in HIV drugs have been successful at keeping people's immune systems healthy with fewer side effects and fewer pills. Despite the tremendous improvements in HIV drugs that now enable most HIV+ people to live long and healthy lives, there are several ways in which living and aging with HIV are different compared to aging while HIV-negative. Some of the health problems of older people appear to happen earlier and faster in HIV+ people (this is sometimes referred to as "accelerated aging").
Scientists are not sure why this happens. It may be that simply being infected with the virus leads to many of the chronic medical conditions associated with aging. HIV infection decreases the ability of the immune system to fight off infections; in this sense, the immune system is 'suppressed.' However, because the immune system of an HIV+ person is always struggling to get rid of the virus, the immune system of HIV+ people is always activated, or "turned on." After many years of being constantly activated, the immune system of people living with HIV may show signs of premature aging.
In addition, an activated immune system produces inflammation. Ongoing inflammation appears to be related to many conditions, including heart disease and cancer.
The drugs used to treat HIV may also contribute to the aging-related health conditions seen in HIV+ people. Although the HIV drugs used now are more effective and less toxic than in previous years, they still may have long-term effects that we do not yet fully understand.
This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.
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