Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions

Abstract

Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. Similarities between aging and the courses of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome suggest that HIV infection compresses the aging process, perhaps accelerating comorbidities and frailty. In a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the HIV Medical Association, the National Institute on Aging, and the National Institute on Allergy and Infectious Diseases, researchers in infectious diseases, geriatrics, immunology, and gerontology met to review what is known about HIV infection and aging, to identify research gaps, and to suggest high priority topics for future research. Answers to the questions posed are likely to help prioritize and balance strategies to slow the progression of HIV infection, to address comorbidities and drug toxicity, and to enhance understanding about both HIV infection and aging.

Figure 1

Age distribution (in years) of HIV-infected individuals living in the United States (reproduced with permission from Luther et al. [2]).

Figure 2

Risk for HIV seroconversion by age (based on data from Plankey et al. [3])

Figure 3

Reductions in aerobic capacity (VO₂) in HIV-infected patients aged 30–80 years (reproduced with permission from Oursler et al. [100]). Data on healthy subjects are shown in blue, and data on HIV-infected patients are shown in red.

Figure 4

Causes of death in the Data Collection on Adverse Events in Anti-HIV Drugs study (based on data from Hooshyar et al. [137]).