Ageing with HIV: a multidisciplinary review.

A Calcagno, S Nozza, C Muss, B M Celesia, F Carli, S Piconi, G V De Socio, A M Cattelan, G Orofino, D Ripamonti, A Riva, G Di Perri

Journal: Infection 2016;43(5):509-22

PMID: 25987480

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Abstract

INTRODUCTION

After the introduction of highly active antiretroviral treatment, the course of HIV infection turned into a chronic disease and most of HIV-positive patients will soon be over 50 years old.

MATERIAL AND METHODS

This paper reviews the multiple aspects that physicians have to face while taking care of HIV-positive ageing patients including the definitions of frailty and the prevalence and risk factors of concomitant diseases. From a therapeutic point of view pharmacokinetic changes and antiretroviral-specific toxicities associated with ageing are discussed; finally therapeutic approaches to frailty are reviewed both in HIV-positive and negative patients.

CONCLUSION AND DISCUSSION

We conclude by suggesting that the combined use of drugs with the least toxicity potential and the promotion of healthy behaviours (including appropriate nutrition and exercise) might be the best practice for ageing HIV-positive subjects.

Address: Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy. [email protected].; Department of Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy.; Centro di Valutazione e Ricerca Gerontologica, University of Modena and Reggio Emilia, Modena, Italy.; Division of Infectious Diseases, Department of Clinical and Molecular Biomedicine, University of Catania, ARNAS Garibaldi, Catania, Italy.; Department of Mother, Child and Adult Medicine and Surgical Science, Infectious Diseases Clinic, University of Modena and Reggio Emilia, Modena, Italy.; 1st Division of Infectious Diseases Unit, University of Milano, Ospedale L. Sacco, Milano, Italy.; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria di Perugia, Perugia, Italy.; Unit of Infectious Diseases, Department of Internal Medicine, Azienda Ospedaliera-Universitaria di Padova, Padova, Italy.; Unit of Infectious Diseases, "Divisione A", Ospedale Amedeo di Savoia, ASLTO2, Torino, Italy.; Infectious Diseases Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.; 3rd Division of Infectious Diseases, University of Milano, Ospedale L. Sacco, Milano, Italy.; Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.

DOI: 10.1007/s15010-015-0795-5

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https://doi.org/10.1007/s15010-015-0795-5

MeSH Terms: Aging, Anti-Retroviral Agents, HIV Infections, Humans, Life Style