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As AIDS Patients Age, A Complex Health Picture Emerges

by Kilian Melloy
Tuesday May 31, 2011
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AIDS patients who survived the first wave of the epidemic are now reaching the age when they might have expected to encounter health issues even apart from HIV. But the picture is complicated by the long-term effects of living with the disease, as well as by the medications they have taken to keep the virus in check, the AFP reported on May 30.

The long-term effects of living with the disease can include diminished memory, chronic neuropathy (nerve pain), and premature aging of the body’s systems.

The article noted that older AIDS patients sometimes live not only with the physical stress of the virus and their pharmaceutical regimens, but also financial hardship and isolation.

"I’ve often said to my doctors, ’You’re so worried about the AIDS but I’m gonna drop over from a heart attack,’" was how one longtime AIDS patient, Lou Grosso, 57, put it. "It bothers me; I’m having a good life and don’t want it to be cut short because my body thinks I’m 80."

A National Institutes of Health news release from last September explained some of what patients who have lived with the disease over the long term may face.

"In those with long-term HIV infection, the persistent activation of immune cells by the virus likely increases the susceptibility of these individuals to inflammation-induced diseases and diminishes their capacity to fight certain diseases," the release said.

"Coupled with the aging process, the extended exposure of these adults to both HIV and antiretroviral drugs appears to increase their risk of illness and death from cardiovascular, bone, kidney, liver and lung disease, as well as many cancers not associated directly with HIV infection.

"In addition, a growing number of adults in their 40s and 50s with long-term HIV infection are experiencing syndromes that resemble premature aging," the release added.

That could mean greater risk of kidney failure, hypertension, osteoporosis, general frailty, mental diminishment, or some combination of health issues.

"A recent study found that 52 percent of HIV positive Americans suffer from some type of cognitive impairment," the AFP article said. "Only 10 percent of people in the general population, by contrast, experience such problems, according to the CNS HIV Antiretroviral Therapy Effects Research study."

Text at emedicine.medscape.com confirms that the virus affects the human central nervous system.

"Physicians frequently encounter neurologic and psychiatric complications in patients with human immunodeficiency virus (HIV) infection," the text reads. "This is not surprising, since HIV enters the central nervous system (CNS) early in the course of the infection."

Typically, however, dementia is less a problem in the short term for patients who are on an effective drug regimen.

"The development of dementia is usually delayed until severe immunodeficiency develops," the text states.

But over the long term, even patients who successfully manage their viral loads may find that they exhibit some degree of neurological impact, albeit usually comparatively minor.

"The rate of impairment in patients with HIV is much, much higher," Dr. Victor Valcour said last year at the 2010 International AIDS Conference, an Aug. 31, 2010, article at The AIDS Beacon reported. "About half of patients who have HIV will have abnormal testing," added Valcour, who is associated with San Francisco’s Memory and Aging Center at the University of California.

The AFP article noted that older AIDS patients might also be at higher risk for cancer.

Next: HIV Hard on Elders



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