FACING THE CHALLENGES OF AGEING WITH HIV
Advances in treatment have dramatically improved the life expectancy of people living with HIV (PLHIV), which is welcome progress. However, challenges remain for those ageing with HIV.
Michael Dorosh was first diagnosed with HIV in 1990, and in 1995, when he started to experience a rapid decline in health, he believed he only had a year left to live. However, thanks to advances in treatment, he has now been living with HIV for more than half of his life.
Now a long-term survivor and Director of the Treatment Educat10n Network (TEN) in Denver, Colorado, Michael acknowledges that challenges and uncertainties remain when it comes to getting older with HIV, and said “people living with HIV may experience age-related health challenges earlier than usual.”
Significant advances have been made in the development of effective HIV treatments that allow PLHIV to suppress their virus to undetectable levels, shifting the prognosis from a fatal infection to the management of a chronic illness. As a result of these advances, PLHIV increasingly live longer and healthier lives and increasingly can expect to live as long as those who do not have HIV.
Despite notable progress in HIV treatment, challenges remain for those ageing with HIV. Andrew Clark, Global Medical Lead at ViiV Healthcare said, “There are medical challenges for those who become resistant to HIV medicines; adherence challenges for those who have difficulty sticking to daily medication, and the additional pressure of having to manage other medical conditions, known as ‘co-morbidities.’ Additionally, these individuals may also face significant social challenges such as a lack of access to care and experiencing stigma.”
Michael Dorosh notes that our immune systems evolved over millions of years by fighting pathogens then going into rest. When our immune system fights, it leads to inflammation.
“What we discovered was that even though your virus might be undetectable, your immune system is still fighting something 24/7, and that might be one of the reasons why people living with HIV may experience health challenges earlier than usual.” – Michael Dorosh, Director of the Treatment Educat10n Network (TEN).
Scientists are looking into multiple sources and studies to better understand ageing in PLHIV and are investigating the potential therapeutic treatments or interventions that could be combined with ART to improve outcomes for PLHIV.
What about stigma?
While ART and HIV management has continued to improve, social and health consequences of stigma have persisted and, in many countries, increased. As Michael Dorosh notes, “HIV is now a treatable chronic disease with few complications, but the disease we have no treatment for is stigma.”
“HIV is now a treatable chronic disease with few complications, but the disease we have no treatment for is stigma.”
Michael Dorosh, Director of the Treatment Educat10n Network (TEN)
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