Human immunodeficiency virus infection in the elderly

Choe, Pyoeng Gyun; Kim, Nam Joong

Abstract

The proportion of human immunodeficiency virus (HIV) infected patients aged 50 and older has greatly increased since the beginning of the epidemic, particularly after the introduction of combination antiretroviral therapy. In Korea, 25% of those infected with HIV were older than 50 in 2009. Older untreated patients with HIV demonstrate faster rates of CD4 lymphocyte loss and more rapid progression to acquired immunodeficiency syndrome and death than younger individuals. Most studies have shown that compared with younger patients, patients over 50 generally have a slower immunologic response to antiretroviral therapy, despite a better virological response. Management of HIV infection in older patients is particularly complex, mainly because they are more likely to have co-morbidities necessitating specific medications that may interact with antiretroviral drugs. Patients living longer with HIV are more likely to develop diseases associated with aging, and at an earlier age, than those without HIV. These include dementia, coronary artery disease, dyslipidemia, metabolic syndrome, diabetes, and osteoporosis.