NAPWA

A 25-year-old who is diagnosed with HIV today has roughly the same life expectancy as someone of the same age who does not have the disease.

So began Dr Anton Pozniak, an HIV specialist from the UK, who spoke to a group of Australian HIV doctors in Sydney, recently.

His theme was HIV and ageing and whether we were all being a bit premature worrying about the issue.

Certainly, some age-related conditions are more prevalent amongst people with HIV. And some are being seen earlier. Frailty, for example, is being observed in PLHIVPerson (or people) Living with HIV. This term is now preferred over the older PLWHA. over the age of 55 while it is generally only seen in people over 65.

Cardiovascular disease is also more of a risk for people with HIV but how much is due to HIV and its treatments and how much to other factors is difficult to extrapolate, Dr Pozniak believes. Most clinicalPertaining to or founded on observation and treatment of participants, as distinguished from theoretical or basic science. events are seen in patients with other standard risk factors. And many of these risk factors, including smoking, alcohol and other drug use, in particular, are more prevalent in the groups of people for whom HIV is also more prevalent.

These ‘lifestyle issues’ can impact on a range of comorbidities.

They pose a risk for developing bone problems and reducing bone mineral density, for example. So, any increased fracture risk we are seeing amongst older PLHIV could also be due to alcohol and other drug use, smoking and lack of exercise.

The risk of kidney disease is greater in older people with HIV. But older people have a reduced liverA large organ, located in the upper right abdomen, which assists in digestion by metabolising carbohydrates, fats and proteins, stores vitamins and minerals, produces amino acids, bile and cholesterol, and removes toxins from the blood. blood flow anyway, so this is not surprising, particularly when it is exacerbated by any ongoing inflammation caused by HIV.

How we treat inflammation is an important next step in HIV management, and Dr Pozniak believes that this is an area where trials are urgently needed.

Take home message for older PLHIV: exercise more, drink less, eat well and stop smoking.

His guidelines for physicians treating older PLHIV are relatively simple.

They include early ARVA medication or other substance which is active against retroviruses such as HIV. intervention, maintaining an undetectable viral loadA measurement of the quantity of HIV RNA in the blood. Viral load blood test results are expressed as the number of copies (of HIV) per milliliter of blood plasma. and a high CD4 count, regular monitoring including fasting lipids and glucose, and screening for bone disease, cancers and renal function.

And for older PLHIV themselves? Exercise more, he says. Drink less. Eat well. And stop smoking.