People with HIV are living longer than ever before, but as a result they must contend with other chronic health conditions, such as cardiovascular disease, pulmonary hypertension, anemias and other blood-related disorders, sleep disorders and certain cancers. In recognition of the long-term survivors of the epidemic and to raise awareness of their needs, HIV Long-Term Survivors Day is held annually on June 5.
According to the NIH, there are approximately 1.1 million people aged 13 years or older in the United States living with HIV.
“With the benefit of ART, many people who are infected with HIV will live into their golden years,” Sean Altekruse, DVM, PhD, MPH, from the NIH’s National Heart, Lung, and Blood Institute, told Infectious Disease News. “Today, almost half of people living with HIV in the United States are 50 years of age and older. With effective ART, these people are more likely to develop chronic diseases, or comorbidities, than they are to develop AIDS-related diseases.”
Previously, the Multicenter AIDS Cohort Study, or MACS, and the Women’s Interagency HIV Study, or WIHS, were conducted as separate, nationwide studies. But this year, MACS and WIHS were combined to create a multi-institutional, collaborative study funded by NIH.
“The MACS/WIHS-CCS project aims to identify biomarkers and risk factors that are associated with increased risk for chronic disorders among people living with HIV,” said Altekruse, who is a program officer for the MACS/WIHS-CCS. “Findings from the project will be used to develop even more effective interventions and treatments for HIV and related comorbidities.”
The study will also focus on the impact age, sex, race/ethnicity and HIV status have on chronic diseases.
“A primary goal of the study is to understand and thus promote processes that enable healthy aging among people living with HIV,” Altekruse said.
In honor of HIV Long-Term Survivors Day, Infectious Disease News compiled recent stories detailing the challenges facing aging people living with HIV.
Menopause worsens fatigue, muscle aches in women with HIV
Researchers at Columbia University found evidence that fatigue and muscle aches — two of the most common symptoms among patients with HIV — are exacerbated by menopause. Read more.
Aging HIV population face complicated rheumatologic care
As the national population of patients who are HIV-positive continues to age, rheumatologists will be increasingly called on to manage routine care for crystal disease, osteoarthritis, soft tissue rheumatism and other conditions, according to Leonard Calabrese, DO, of the Cleveland Clinic. Read more.
Subclinical findings may explain heart failure risk in women with HIV
Asymptomatic aging women with HIV who are being treated with ART exhibited increased myocardial fibrosis and reduced diastolic function compared with women who are not infected with HIV, according to study results. Read more.
Fatty liver prevalence, mortality rising in HIV population
As HIV reaches new levels of control and hepatitis C virus treatments give cures, providers must be aware that non-alcoholic fatty liver disease is on the rise in the population with HIV as it is in the general population. Read more.
Hepatic steatosis common in young adults with life-long HIV
Thirty-three percent of young adults with HIV since birth or early childhood have hepatic steatosis, a prevalence comparable to older adults with HIV and “significantly higher” than HIV-negative controls. Read more.
HIV infection linked to shorter survival in hepatocellular carcinoma
HIV seropositivity appeared associated with shorter OS among patients with hepatocellular carcinoma despite sufficient ART, according to results of a global multicohort study published in Journal of Clinical Oncology. Read more.
Frailty associated with adverse health outcomes, mortality in HIV-infected adults
Study findings showed that frailty is associated with risk for incident cardiovascular disease, diabetes and bone disease in people living with HIV, and that an increase in frailty is associated with mortality in patients with HIV who are engaged in care. Read more.
Patients with HIV prone to coronary endothelial dysfunction
Adults treated for HIV had elevated serum PCSK9 levels and abnormal coronary endothelial function, researchers reported. They compared 48 patients with HIV (mean age, 52 years; 81% men) who were receiving ART and had suppressed viral replication and no CAD with 15 healthy controls (mean age, 49 years; 47% men) matched for age and LDL level. Read more.
Fewer than 10% of people with HIV complete advance care planning
Among eligible people living with HIV at the National University Hospital in Singapore, fewer than 10% completed advance care planning, according to findings presented at IDWeek. Read more.
Global burden of HIV-related CVD on the rise
The global burden of CVD associated with HIV has tripled in the past 2 decades, with the greatest burden in Asia-Pacific and sub-Saharan Africa regions, according to a review published in Circulation. Read more.
NIH. MACS/WIHS Combined Cohort Study. https://www.nhlbi.nih.gov/science/macswihs-combined-cohort-study. Accessed June 4, 2019.