This is a retrospective controlled cohort study of deaths in the ART era (1996-2012) in British Columbia. The mortality rate of HIV-infected patients has declined by 96% but remains about 3 times higher than in the HIV-uninfected population. Deaths due to non-HIV related causes now account for about 75% of all deaths in the HIV infected population. Cancers remain the largest cause of death in this HIV-infected cohort.
HIV infection itself is a risk factor for kidney disease in the older HIV-infected patient compared to matched HIV-uninfected patients. The HIV-infected group was twice as likely to have a decline in renal function and 6 times as likely to have proteinuria. Interestingly, another strong predictor of worsening kidney disease was not having ART modified at the onset of renal dysfunction. This finding illustrates how important it is for clinicians to carefully monitor kidney function in virologically stable older patients, and to consider modifying ART with changes in renal markers.
In this well-designed case-cohort study of age-matched HIV-infected and -uninfected older adults with HIV from the MACS group, a measurable decline in cognitive function was seen in older infected patients. Five domains of cognition were measured and all were affected with increasing age compared to the uninfected controls. Older subjects with late-stage HIV-infection showed severe declines in the two domains of episodic memory and motor function.
A cross-sectional study assessed 3258 adults (2248 MSM, 373 heterosexual men, and 637 women) with HIV in the UK. Median age was 45, 56% reported physical symptoms of distress; 27% depression; 22% anxiety; 38% functional problems. They found that the prevalence of depression and anxiety decreased with age while functional problems increased with age. There was no association between age and physical symptoms of distress. Longer duration of living with HIV infection was strongly associated with higher prevalence of physical distress symptoms, depression, anxiety, and functional problems.
This study assessed 29 HIV-positive adults over the age of 50 living in U.S. rural counties. Using thematic content analysis, they examined the nexus of aging and HIV to identify factors that affects overall health, engagement in care, and medication adherence These older adults were more concerned with health conditions other than HIV. Lack of concern for HIV were attributed to fewer HIV-related complications, degree of comfortability and the number of years living with HIV.
National surveys were used to assess the distribution and characteristics of malignancy-related deaths among HIV patients in 2010, and compared them to 2000 and 2005. Cancer is the leading cause of mortality in the HIV-infected patients studied. The risk of malignancies, including non-AIDS-related cancers, is higher in HIV patients than in the general population. Smoking is reported to be the primary risk factor in non-AIDS-related cancer, particularly lung cancer.
A randomized control trial assessed HIV knowledge, treatment, beliefs and attitude of women who had previously received PMTCT (prevention-of-mother-to-child-transmission) [PMTCT] and were about to commence ART. Of the 320 women studied, mean age was 33, 106 had previously received PMTCT, while 214, had never received ART. Using multivariate linear regression analysis, higher HIV insights was associated with prior PMTCT participation. ART naïve-women expressed stronger beliefs that ART would pose a problem, when compared to those who had previously received PMTCT.
This study conducted an integrative review of 29 articles to assess and compare emerging themes in the social network component of rural versus urban-dwelling older people living with HIV (OPLWH). Themes discovered in both rural and urban-based literature were similar, and revealed perceived lack of social networks and social support, heightened stigma, fragmented social support, and increased social isolation among OALWH. Unlike urban communities, rural OALWH faced added challenges such as socioeconomic burdens, lack of quality healthcare facilities, and inadequate HIV resources.
In a 2016 study researchers examined patterns of cardiovascular disease (CVD) mortality for HIV-infected adults between 1999-2013. Total and proportionate cardiovascular disease mortality in HIV-infected adults was compared to the general population and those with another chronic inflammatory condition, inflammatory polyarthroplasty. Total mortality in HIV-infected men and women decreased from 15,739 to 8660. CVD mortality significantly increased from 307 to 400 during the same period.
A recent systematic review examined the safety and effectiveness of aerobic exercise interventions on several health outcomes in HIV-infected adults. This was an update of a previous systematic 2010 review of 14 studies. Authors searched 11 databases for studies published between 2009 and April 2013. Randomized controlled trials of HIV-infected adults that compared aerobic exercise to no exercise or another exercise intervention performed at least three times per week for at least four weeks were included.
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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