HIV and ageing: what the geriatrician needs to know

Abstract

SummaryThe transformation of human immunodeficiency virus (HIV) from a rapidly fatal disease to a chronic manageable illness has resulted in annual increases in the numbers of people living with HIV. The HIV cohort is therefore ageing, with numbers of older adults with HIV climbing, through both prolonged survival and late acquisition of the disease. Associated with ageing is an accumulation of HIV-associated non-AIDS related co-morbidities, creating a complex patient group affected by multi-morbidity along with polypharmacy, functional decline and complex social issues. With this in mind, this review seeks to explore areas where HIV (diagnosed or undetected) may impact on the work of clinical geriatricians.

Specialist care of older adults with HIV infection in the UK: a service evaluation

“…This study has shown examples of geriatrician involvement as has other literature . There is also an increasing literature aimed at informing geriatricians of the issues pertinent to ageing in PLWH [).…”

Aging with HIV vs. HIV Seroconversion at Older Age: A Diverse Population with Distinct Comorbidity Profiles

“…A particular concern in this population regards MM as a predictor care complexity and polypharmacy increasing the cost of clinical management[ 17 ]. Moreover polifarmacy rises risks of pharmacological interactions and medical errors[ 18 – 20 ]. Ageing and chronic HIV infection can also both contribute to subclinical changes, including atherosclerosis, bone mineral density, and changes in T cell function.…”

HIV pada Geriatri HIV in Geriatrics

“…Sejak highly active anti-retroviral therapy (HAART) diperkenalkan pada tahun 1996 dan dimulai terapi anti retroviral kombinasi, pasien HIV yang terdiagnosis awal dan mendapat terapi antiretroviral dapat hidup seperti orang normal pada umumnya. 1 Pada penelitian yang dilakukan oleh Greene, dkk. 2 ditemukan rentang waktu terpanjang dari pasien terdiagnosis HIV hingga saat penelitian dilakukan mencapai 21 tahun.…”

“…Untuk mencapai successful ageing, seorang individu harus menjaga kondisi fisik, mental dan diterima secara sosial. 1 Pasien geriatri dengan HIV mengalami kemunduran fisik serupa dengan pasien tanpa HIV yang berusia 20-30 tahun lebih tua. Ada beberapa faktor yang menyebabkan terjadinya kondisi tersebut.…”

“…Faktor tersebut meliputi aktivitas fisik yang rendah, artritis, nyeri yang mengganggu aktivitas, gangguan kejiwaan, komorbid dan polifarmasi. 1 Faktor penerimaan sosial dinilai berpengaruh terhadap permasalahan untuk mencapai successful aging. Pada sebuah penelitian ditemukan bahwa 57% pasien geriatri dengan HIV merasa memiliki kebutuhan emosional yang tidak terpenuhi dan 79% harus dibantu dalam IADL.…”