HIV-AIDS and Aging: Challenges and Management

The infection of a healthy person with human immunodeficiency virus type 1 (HIV-1) causing acquired immunodeficiency syndrome (AIDS), is a serious public health threat around the world. In the United States, approximately 80,000 (6 percent) of known cases of HIV are 50 years of age and older and about 11 percent of all US cases of AIDS are in this age group. AIDS has been identified as the 15th leading cause of death in those over 65 years of age in the United States similar to other developed countries of the world. UNAIDS and WHO have estimated that out of the 40 million people living with HIV/AIDS in the world, approximately 2.8 million were 50 years and older. As treated HIV-infected patients live longer and the number of new HIV diagnoses in older patients rise, clinicians need to be aware of these trends and become familiar with the management of HIV infection in the older patients. Long-term treated HIV infected patients remain at higher than expected risk for cardiovascular disease, cancer, osteoporosis, and other diseases along with a number of complications typically associated with aging. However, additional research is needed to generate deeper insights regarding mutual impacts of HIV infection and aging in order to develop and implement effective prevention measures for safe antiretroviral therapy in the older HIV-infected patient. No guidelines are available as on date to specifically address the needs of the elderly HIV-infected patient. This article illustrates the recent updates on current global scenario of HIV-AIDS, aging, complications due to HIV infection and application of antiretroviral treatment (ART), aging and medical management strategies which might be useful for health care agencies and policy makers involved in addressing such issues associated to the older HIV-infected patients.