With the success of highly active anti-retroviral therapy (HAART) medications, the greying of HIV/AIDS is surely a thing. At my clinic you can often hear someone saying, with a big smile scrolled across their face, “I’m 25 years in.” This is a strong contrast to the death toll that many of us saw back in the day. For sure this is a good thing and the medical community is looking closely at what this means for those living with HIV/AIDS and aging.
The fact of the matter is everyone’s HIV/AIDS is different. This is true from the strand of the virus you are infected with, to how early you enter into treatment. This also includes what damage was done to the body or not, prior and even during treatment. For example, I was diagnosed with irritable bowel syndrome (IBS) about seven years ago. My doctors believe this is a by-product of taking the earlier HIV medications that were so much more toxic then the ones today. So the management of my health requires more than an HIV doctor but also a gastroenterologist. While my situation may differ from yours, there are some commonalities among those aging with HIV.
For sure, those living with HIV have a higher rate of age-related conditions than those aging without HIV. STOP! Yes, I’m saying what you think I’m saying. Not only do we have to manage HIV disease for the rest of our lives, we also have to manage our overall health with a fine tooth comb. There is an acceleration of heart disease, kidney disease, non-HIV cancers, osteoporosis and even issues related to the central nervous system. Even our life expectancy is lower than those aging without HIV.
As for the causes, there is still so much to learn about HIV and aging because many of us our aging parallel to the disease. However, there are a few things that we do know about the acceleration of these diseases for those living with HIV. First off, HIV causes damage to our cells and organs and while some changes are slowed by anti-retroviral medications, some of those medications are also responsible for damage to our internal body.
Chronic inflammation is another big culprit for those living with HIV. When we first become infected, HIV attacks our body causing the immune system to kick in and fight back. This process, in turn, creates inflammation. Not all of the early damage is reversed once you begin HAART. Even if your viral load is undetectable, HIV is still replicating at low levels in your body, but enough for the immune system to respond, leaving you in a state of constantly making low level inflammation. Inflammation has been known to be a contributing factor to many of the health conditions I mentioned earlier, like heart disease and osteoporosis.
I know that it is a lot to think about, but for sure we can altar our lifestyle to combat some of these aging issues. Let me leave you with this, something you probably already know. The first line of defense for an aging body is to consume a low fat diet, including fruits and vegetables, exercise at least 30 minutes a day, rest and drink lots of water.
When I first started to read about aging with HIV I wanted to scream and I did. But I also want to live. So I have made changes, but frankly not enough and not consistently, so let’s do this together because one day living with HIV is too long to throw in the towel now.