NIH Research on HIV and Aging
Further, research studies have shown that HIV disease itself and/or its treatment appear to affect the process of aging or the development of illnesses associated with aging. For example, the NIH-sponsored Multicenter AIDS Cohort Study has shown that HIV disease accelerates the development of chronic diseases. Older adults with long-term or new HIV infection experience complex interactions with HIV, antiretroviral therapy (ART), age-related changes to the body, and, often, treatment for illnesses associated with aging. These conditions include cardiovascular disease, infectious and noninfectious cancers, osteopenia/osteoporosis, liver and renal disease, and neurocognitive decline. Globally, research in Sub-Saharan Africa, the geographic area where most HIV-infected people live, suggests that this trend is also occurring in resource-limited settings. These findings have many clinical, social and economic ramifications and will pose a number of challenges to provide effective health care to an increasing number of HIV-infected individuals.
The trans-NIH AIDS strategic plan (PDF) has made AIDS and aging a research priority. To identify specific research gaps and strategies, in 2011 the NIH established a working group comprised of scientists, clinicians, community representatives and other experts on areas related to HIV/AIDS and gerontology. The HIV and Aging Working Group prepared a Report to the NIH Office of AIDS Research, “HIV and Aging: State of Knowledge and Areas of Critical Need for Research,”
Research in this area must address:
- multi-morbidity, i.e. the development of multiple chronic conditions that complicate HIV disease;
- the complexity of distinguishing what complications are attributable to HIV, to its treatment, or to the aging process;
- the simultaneous use of a large number of HIV and non-HIV medicines;
- the inter-related mechanisms of aging of the immune system, inflammation and coagulation disorders;
- the need for accurate methods to identify HIV-infected patients who need specific interventions or are at high-risk for specific complications; and
- issues of community support, care giving and systems infrastructure.
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