This article previously appeared on HIV Update, a service of aidsmap.com.
Across the world, over 4 million people aged 50 years or over are living with HIV, a United Nations report shows. The largest number of older people with HIV are living in African countries – 2.5 million people.
Older people therefore make up a growing proportion of the total 35 million people who are living with HIV. The main reason for the growth is the success of HIV treatment in keeping people alive and healthy. Another reason is that an increasing number of people acquire HIV when they are over 50, showing that HIV prevention programmes cannot ignore this age group.
The research also indicates that medical and social services will need to adapt to address the often complex needs of older people living with HIV. This is especially important because living with HIV has been associated with an increased risk of diseases associated with old age.
More evidence of this was recently published, from researchers in the Netherlands. They compared the health outcomes of around 500 people living with HIV over the age of 45, and those of 500 people who do not have HIV. Those in the HIV-negative group were ‘matched’ with those living with HIV, meaning that they were of a similar age (average 52 years), gender (most were men), sexuality (most were gay) and nationality (most were Dutch).
Many of those living with HIV had been diagnosed for ten years or more. Almost all were taking HIV treatment and had an undetectable viral load.
People living with HIV were more likely to have a disease associated with ageing:
. 45% had high blood pressure, compared to 31% of those without HIV.
. 4% had had a heart attack, compared to 2%.
. 3% had peripheral arterial disease (build-up of fatty deposits in the arteries restricting blood supply to leg muscles), compared to 1% of those without HIV.
. 4% had kidney problems, compared to 2%.
This appears to be partly due to having HIV and to damage to the immune system. People who had previously had a CD4 cell count below 200 for a longer period were more likely to have these diseases. Scientists think this may accelerate the ageing process.
But it also seems to be due to differences in lifestyle. Those living with HIV were more likely to smoke, less likely to be physically active or get any exercise, and more likely to have too much fat around their stomach (a high waist-to-hip ratio).
When members of a person’s family had previously had heart disease or diabetes, this also raised the risk of these problems occurring. Changes to lifestyle can be especially important when there is a family history of heart disease.