HIV and aging: time for a new paradigm.

Justice, Amy C.

doi:10.1007/s11904-010-0041-9

Cited by 310HIV-related health complications and treatmentsHIV/AIDS Research and InterventionsHIV Research and Treatment

HIV and aging: time for a new paradigm.

Justice, Amy C.·2010·Current HIV/AIDS Reports

DOI 10.1007/s11904-010-0041-9

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Abstract

The population of patients with HIV infection achieving viral suppression on combination antiretroviral therapy is growing, aging, and experiencing a widening spectrum of non-AIDS diseases. Concurrently, AIDS-defining conditions are becoming less common and are variably associated with outcome. Nonetheless, the spectrum of disease experienced by those aging with HIV remains strongly influenced by HIV, its treatment, and the behaviors, conditions, and demographics associated with HIV infection. Our focus must shift from a narrow interest in CD4 counts, HIV-RNA, and AIDS-defining illnesses to determining the optimal management of HIV infection as a complex chronic disease in which the causes of morbidity and mortality are multiple and overlapping. We need a new paradigm of care with which to maximize functional status, minimize frailty, and prolong life expectancy. A composite index that summarizes a patient's risk of morbidity and mortality could facilitate this work and help chart its progress.

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The cumulative burden of HIV-related complications reduces a person's ability to compensate and respond to many events, which collectively results in onset of frailty and other geriatric syndromes.
“The cumulative burden of these complications reduces a person’s ability to compensate and respond to many events, which collectively results in onset of frailty and other geriatric syndromes (15, 17, 48).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [17]
eGFR is an important component in multi-variate models of mortality and hospitalization in HIV-infected persons.
“However, eGFR can be readily obtained from standard blood chemistry panels and is an important component in multi-variate models of mortality and hospitalization in HIV-infected persons (15, 17, 48, 55).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [17]
Anemia and RBC size/shape are important indicators of mortality and hospitalization risk in multivariate analyses.
“A number of studies have noted the importance of anemia and RBC size/shape (typically measured by mean cell volume (MCV) and red blood cell distribution width (RDW), respectively) as important indicators of mortality and hospitalization risk in multivariate analyses (17).”
From HIV and Aging: State of Knowledge and Areas of Critical Need for Research. A Report to the NIH Office of AIDS Research by the HIV and Aging Working Group (2012) · cites this paper as [17]

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HIV and ageing
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HIV and aging
Chirch, L. M., Hasham, M., & Kuchel, G. A. (2014) · Current Opinion in HIV and AIDS · doi:10.1097/coh.0000000000000074 · Cited by 12 · see citing works
. Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions.
Effros, R. B., Fletcher, C. V., Gebo, K., Halter, J. B., Hazzard, W. R., Horne, F. M., Huebner, R. E., Janoff, E. N., Justice, A. C., Kuritzkes, D., et al. (2008) · Clinical Infectious Diseases · doi:10.1086/590150 · Cited by 539 · see citing works
Self-citation
Curare la malattia da HIV: ritorno al paziente?
Girardi, E., Monforte, A. D., Camoni, L., Pezzotti, P., Guaraldi, G., Ammassari, A., Antinori, A., Bonora, S., Mussini, C., Cingolani, A., et al. (2016) · Recenti Progressi in Medicina · doi:10.1701/2454.25704 · Cited by 3 · see citing works
Geriatric syndromes: How to treat
Cesari, M., Marzetti, E., Canevelli, M., & Guaraldi, G. (2016) · Virulence · doi:10.1080/21505594.2016.1219445 · Cited by 45 · see citing works

Authors: Justice, A. C.
Affiliations: Yale University (US)
Corresponding author: Justice, Amy C.
ORCID: Justice, Amy C.
Venue: Current HIV/AIDS Reports
Publisher: Springer Science and Business Media LLC
Published: 2010-04-13
Volume: 7
Issue: 2
Pages: 69-76
ISSN: 1548-3568 (ISSN-L)
1548-3576
DOI: 10.1007/s11904-010-0041-9
OpenAlex: W2158666805
Cited by: 309
References: 52
Citations by year: 2026: 6 · 2025: 6 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 11 · 2020: 18 · 2019: 25 · 2018: 23 · 2017: 19 · 2016: 24 · 2015: 21 · 2014: 38 · 2013: 37 · 2012: 35
FWCI: 28.63
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Current HIV/AIDS Reports (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Keywords: aging with HIV, non-AIDS comorbidities, highly active antiretroviral therapy, viral suppression, chronic disease management, frailty, functional status, mortality risk, morbidity risk, composite risk index
MeSH terms: Acquired Immunodeficiency Syndrome, Aging, Clinical Trials as Topic, Humans, Middle Aged, Health Behavior, HIV Infections, Comorbidity, Anti-HIV Agents

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HIV and aging: time for a new paradigm.

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