HIV & Aging: Journal Articles

Age at Carotid Surgical Intervention in Adults with HIV

As part of stroke prevention, especially with vascular symptoms, carotid endarterectomy or carotid stenting are often performed. With apparent increased strokes in adults with HIV, a question arises about the frequency and age of such surgical procedures. Using a very large sample of hospital admissions from the Healthcare Cost and Utilization Project, the age, sex, other demographics, comorbidities, and other related variables were collected from medical records on adults with HIV (HIV+) and without HIV (HIV-) over a 10-year period (2004-2014).

Cognitive Decline with Carotid Stiffness But No Difference By HIV Status

Increased vascular stiffness has been found in adults with HIV. A key question is if the vascular stiffness is related to cognitive decline. This issue was investigated in the Women’s Interagency HIV Study, which includes 1662 women with 72% HIV positive and the remainder, similar in demographics, but who are HIV negative. Carotid ultrasound at a single baseline visit was used as a measure of stiffness and longitudinal neuropsychological test results as a measure of cognitive status were determined from 2004-2016.

HIV and Aging May Not Be As Bad?

With mortality from HIV reduced there are more older persons living with HIV. The concern is that diseases and conditions associated with aging will become frequent and result in multimorbidity (MM) in this subgroup. A number of reports, including the one featured above, have reported this increase in MM. However, investigators from Switzerland present a literature review and suggest a possible recent reduction in the frequency of various comorbidities.

Multimorbidity Increases with Age in People with HIV

The question addressed by this report is whether the frequency of multimorbidity (MM) is increasing over time as persons with HIV continue to age. A large cohort of adults with HIV (22,969) gathered from various sites in the US under the auspices of NA-ACCORD (North American AIDS Cohort Collaboration on Research and Design) was used to investigate the cross sectional frequencies of MM by year from 2000 to 2009. Most of the participants in this study were white men with a baseline age of 40 years.

Meeting Basic Needs Affects Quality of Life For People Aging with HIV

An important question is the effect of unmet basic needs, such as food security and stable housing, on persons with HIV. A study to address this question is reported using a cohort of 496 adults with HIV living in Ontario, Canada. Needs were determined by questions, such as: In the last 12 months have you experienced difficulty in buying enough food? and How difficult is it for you to meet monthly housing costs? The outcome variables were derived from the Medical Outcomes Study HIV Health Survey and measured physical health and mental health.

Optimal Aging for Older Adults with HIV: Embracing Geriatric Principles

The lead author, a geriatrician, and her colleagues make a strong case in a recent IAS journal publication that geriatric approaches used with very old persons should be adapted and applied to the care of older adults with HIV. The high frequency of multimorbidity and associated polypharmacy found in the older adult with HIV supports this view. “Comprehensive Geriatric Assessment” (CGA) is commonly used by geriatricians. It assesses medical, social, functional, psychiatric, and other domains. The CGA provides a more comprehensive picture of needs of the older adult with HIV.

More Effort Needed For Herpes Zoster Vaccinations

With better HIV treatment, the frequency of Herpes Zoster (HZ) in older adults with HIV has dropped but is still at least two to three times higher than in persons uninfected with HIV. Also, this subgroup is still vulnerable for complications when infected with HZ. So, many clinicians recommend use of the vaccine in HIV-positive adults 50 and older with an undetectable viral load and a CD4 count over 200. A study at 6 sites was implemented to determine the level of vaccine use at baseline and the effect of two regimens for improvement.

Diabetes in Older Adults with HIV May Be Related to Older Antiretroviral Therapy

There is variability in reports about the presence of an increased frequency of diabetes mellitus (DM) in older persons with HIV. Most suggest an excess than in a comparison group, but the reasons for this increase are unclear. To address this issue, a longitudinal study of adults 50 years or older with HIV was mounted using data from a clinic in Vancouver, Canada. Data from 1065 patients were identified without DM who had a median of 13 years of follow-up. The onset of DM was identified from medical records using standard diagnostic criteria.

HIV Trends in Older Men Who Have Sex With Men

The latest (2016) HIV frequency estimate from CDC indicates that two thirds of infections have involved male-to-male sexual contact. From 2008 to 2016 the annual number of new cases in men who have sex with men (MSM) increased 3% per year in those 13-29 years (total of 106,258) and was stable for those 50 years and older (total of 29,034). Diagnoses did increase among Asians and Hispanic Latinos in the older subgroup. Blacks accounted for 25% of the diagnoses in the older group.

HIV Disparities and the Use of Preexposure Prophylaxis

The FDA approved PrEP (tenofovir and emtricitabine) as a once a day single pill in 2012. Since 2014 the CDC has recommended this form of PrEP because it was found to be safe and very effective in the prevention of HIV in high-risk populations. The authors of this editorial review the realities of the current epidemic, address reasons for the underuse of this method and make suggestions for improvement.

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Purpose of this Program: The AAHIVM, ACRIA and AGS (collectively, the “Sponsors,” “we” or “us”) are sponsors of this Website and through it seek to address the unique needs and challenges that older adults of diverse populations living with HIV face as they age. However, the information in this Website is not meant to supplant the advice provided in a doctor-patient relationship.

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The American Academy of HIV Medicine is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease. Our membership of HIV practitioners and credentialed HIV Specialists™, HIV Experts™, and HIV Pharmacists™ provide direct care to the majority of HIV patients in the US.