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Review
. 2013 Apr 3;309(13):1397-405.
doi: 10.1001/jama.2013.2963.

Management of human immunodeficiency virus infection in advanced age

Meredith Greene  1 , Amy C Justice, Harry W Lampiris, Victor Valcour
Affiliations
Review

Management of human immunodeficiency virus infection in advanced age

Meredith Greene et al. JAMA. .

Abstract

Importance: Human immunodeficiency virus (HIV)-positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients.

Objective: To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed.

Evidence acquisition: Published guidelines and consensus statements were reviewed. PubMed and PsycINFO were searched between January 2000 and February 2013. Articles not appearing in the search that were referenced by reviewed articles were also evaluated.

Findings: The population of older HIV-positive patients is rapidly expanding. It is estimated that by 2015 one-half of the individuals in the United States with HIV will be older than age 50. Older HIV-infected patients are prone to having similar chronic diseases as their HIV-negative counterparts, as well as illnesses associated with co-infections. Medical treatments associated with these conditions, when added to an antiretroviral regimen, increase risk for polypharmacy. Care of aging HIV-infected patients involves a need to balance a number of concurrent comorbid medical conditions.

Conclusions and relevance: HIV is no longer a fatal disease. Management of multiple comorbid diseases is a common feature associated with longer life expectancy in HIV-positive patients. There is a need to better understand how to optimize the care of these patients.

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References

    1. Antiretroviral Therapy Cohort Collaboration. Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies. Lancet. 2008;372(9635):293–299. - PMC - PubMed
    1. Prejean J, Song R, Hernandez A, et al. HIV Incidence Surveillance Group. Estimated HIV incidence in the United States, 2006–2009. PLoS One. 2011;6(8):e17502. - PMC - PubMed
    1. Linley L, Prejean J, An Q, Chen M, Hall HI. Racial/ethnic disparities in HIV diagnoses among persons aged 50 years and older in 37 US States, 2005–2008. Am J Public Health. 2012;102(8):1527–1534. - PMC - PubMed
    1. Jacobs RJ, Kane MN. Theory-based policy development for HIV prevention in racial/ethnic minority midlife and older women. J Women Aging. 2009;21(1):19–32. - PubMed
    1. Smith RD, Delpech VC, Brown AE, Rice BD. HIV transmission and high rates of late diagnoses among adults aged 50 years and over. AIDS. 2010;24(13):2109–2115. - PubMed

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