HIV and ageing: improving quantity and quality of life
File(s)
Accepted version
Author(s)
Althoff, KN
Smit, M
Reiss, P
Justice, AC
Type
Journal Article
Abstract
Purpose of review
Evidence-based strategies are needed to address the growing complexity of care of those ageing with HIV
so that as life expectancy is extended, quality of life is also enhanced.
Recent findings
Modifiable contributing factors to the quantity and quality of life in adults ageing with HIV include: burden
of harmful health behaviours, injury from HIV infection, HIV treatment toxicity and general burden of ageassociated
comorbidities. In turn, these factors contribute to geriatric syndromes including multimorbidity
and polypharmacy, physiologic frailty, falls and fragility fractures and cognitive dysfunction, which further
compromise the quality of life long before they lead to mortality.
Summary
Viral suppression of HIV with combination antiviral therapy has led to increasing longevity but has not
enabled a complete return to health among ageing HIV-infected individuals (HIVþ). As adults age with
HIV, the role of HIV itself and associated inflammation, effects of exposure to antiretroviral agents, the high
prevalence of modifiable risk factors for age-associated conditions (e.g. smoking), and the effects of other
viral coinfections are all influencing the health trajectory of persons ageing with HIV. We must move from
the simplistic notion of HIV becoming a ‘chronic controllable illness’ to understanding the continually
evolving ‘treated’ history of HIV infection with the burden of age-associated conditions and geriatric
syndromes in the context of an altered and ageing immune system.
Evidence-based strategies are needed to address the growing complexity of care of those ageing with HIV
so that as life expectancy is extended, quality of life is also enhanced.
Recent findings
Modifiable contributing factors to the quantity and quality of life in adults ageing with HIV include: burden
of harmful health behaviours, injury from HIV infection, HIV treatment toxicity and general burden of ageassociated
comorbidities. In turn, these factors contribute to geriatric syndromes including multimorbidity
and polypharmacy, physiologic frailty, falls and fragility fractures and cognitive dysfunction, which further
compromise the quality of life long before they lead to mortality.
Summary
Viral suppression of HIV with combination antiviral therapy has led to increasing longevity but has not
enabled a complete return to health among ageing HIV-infected individuals (HIVþ). As adults age with
HIV, the role of HIV itself and associated inflammation, effects of exposure to antiretroviral agents, the high
prevalence of modifiable risk factors for age-associated conditions (e.g. smoking), and the effects of other
viral coinfections are all influencing the health trajectory of persons ageing with HIV. We must move from
the simplistic notion of HIV becoming a ‘chronic controllable illness’ to understanding the continually
evolving ‘treated’ history of HIV infection with the burden of age-associated conditions and geriatric
syndromes in the context of an altered and ageing immune system.
Date Issued
2016-09-01
Date Acceptance
2016-06-29
Citation
Current Opinions in HIV & AIDS, 2016, 11 (5), pp.527-536
ISSN
1746-630X
Publisher
Lippincott, Williams & Wilkins
Start Page
527
End Page
536
Journal / Book Title
Current Opinions in HIV & AIDS
Volume
11
Issue
5
Copyright Statement
© 2016 Wolters Kluwer Health, Inc. All rights reserved.
Subjects
Virology
1117 Public Health And Health Services
Publication Status
Published