Human Immunodeficiency Virus or HIV is the retrovirus that causes Acquired Immunodeficiency Syndrome (AIDS). It was identified in the 1980s and I remember it well. I was a teenager who watched the commercials, read the magazine articles and listened to President Ronald Reagan tell America about it on television. And it frightened the heck out of me. I remember that between 1981 and 1995 the number of diagnoses and people dying continued to increase. I also remember when the first line of drugs came out and made a significant impact saving lives. Today, people are living much longer with HIV due to the effectiveness of the highly active antiretroviral drugs (HAART). What a difference a couple of decades and medications can make.
The Good News and Not So Good News
The good news about HIV today is that people diagnosed with it and remain compliant on their medication will live a long life. HIV is no longer a death sentence. The not so good news is that people with HIV are still aging, and it is unclear how HIV and aging will turn out later in life. In other words, does HIV quicken the aging process? Does it make aging more difficult? And, what about the long term side effects of the HIV medication? What will that do to aging organs and cells? Can the drugs speed up the aging process?
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Aging and HIV: An Epidemic?
We all know the aging population is exploding in the United States and that it’s due to the Baby Boom generation. It is the Boomers who may have contracted HIV earlier in their lives and now they are aging with the virus under control due to medications and lifestyle modifications such as diet and exercise. An interesting trend is that the demographic profile of people living with HIV is shifting to older ages in the United States and in other countries around the world. Many of these people will live a long and healthy life. Others may face physical and mental complications. Some may become isolated and socially withdrawn. Others will move into assisted living and skilled nursing communities. Some will have diminished quality of life and may even age more rapidly than their non-HIV counterparts. Despite great advancement in medicine, some individuals will face serious illnesses due to HIV and related behaviors.
Aging, HIV and Complications
Aging with HIV also means growing old and developing age-related disorders and diseases as well as the co-occurring complications that come along with them. Co-infection with hepatitis B or C, for instance, can lead to liver cancer, liver failure, and kidney disease. Chronic infection with Human Papillomavirus (HPV) can lead to cancers of the head, neck, throat and cervix. People with HIV are three times more likely to smoke, which can lead to heart disease, strike, cancer and emphysema. People with HIV are also more likely to experience psychological problems and substance abuse issues, all making the aging process less healthy and more complicated. As the person ages with HIV, their risk increases for inflammation-related damage to the heart, nervous system, liver and kidneys.
Comorbidity and Multimorbidity
Other areas of concern for people aging with HIV are comorbidity and multimorbidity. Comorbidity simply refers to any disease or risk factors that interacts with HIV, making either condition worse. For instance, depression and alcoholism. Multimorbidity, on the other hand, refers to two or more health conditions interacting with one another, complicating each other and causing complicated health problems. It is also known as polypathology. For example, an individual aging with HIV may also have hypertension, diabetes, liver disease or cognitive impairment due to Alzheimer’s disease. Someone may also have heart disease, renal failure, fractures, and osteoporosis while aging with HIV. It is easy to see how this can all become medically complex and frustrating to live with.
Final Words on Aging with HIV
HIV was once a death sentence and now it is a condition that one can live with as they age. Aging with HIV has its complications. A segment of the population of Boomers in the United States will age with HIV. There are over 1 million people who are aging with HIV, and over half of them are 50 years of age or older. These people will require medical care, assisted living, home health, skilled nursing and eventually hospice. The time is now for healthcare professionals to learn as much as they can about aging with HIV.
(NOTE: Interested in learning more about Neurodegenerative Disorders? Checkout my Neurodegenerative Disorders on CEU Academy and try a FREE CEU today!)