HIV/AIDS in the elderly
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Epidemiology
- 10% of AIDS diagnosis in patients > 50 years (1999)
- 10-fold increase in AIDS in patients > 65 years of age in decade of 1990-2000
- persons most likely to have risky behavior are married men 50-60 years of age
Pathology
- comorbidities contribute to likelihood of AIDS at presentation
- HIV1 progresses faster in the elderly[2]
Complications
- depression (65%)
- AIDS dementia (40%)
- multiple comorbid illness (40% with > 2 comorbid conditions)
- drug-induced hepatitis, hyperlipidemia, peripheral vascular disease, lung cancer, coronary artery disease, peripheral neuropathy, stroke
- cardiovascular disease major cause of mortality
- older women likely to have:
- psychosocial illness, depression, anxiety, substance abuse, psychosis
Management
- adults > 50 & < 50 years of age respond equally well to antiretroviral therapy
- adults > 50 generally sustain 1/2 the rise in CD4 count in response to antiretroviral therapy
- hormone replacement therapy in women associated with increased survival
More general terms
Additional terms
- age-associated changes in immunity; immunosenescence
- elderly (senior citizen)
- human immunodeficiency virus-1 (HIV-1)
References
- ↑ Ardos Moe MD, UCLA Multicampus Program in Geriatric/Gerontology, Lecture series, 02/15/2002
- ↑ 2.0 2.1 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013 - ↑ Luther VP1, Wilkin AM. HIV infection in older adults. Clin Geriatr Med. 2007 Aug;23(3):567-83, PMID: https://www.ncbi.nlm.nih.gov/pubmed/17631234
- ↑ Greene M, Justice AC, Lampiris HW, et al. Management of human immunodeficiency virus infection in advanced age. JAMA. 2013;309:1397-1405 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23549585
- ↑ HIV, AIDS, and Older People http://www.niapublications.org/engagepages/aids.asp