The aging HIV population

Clin. Pract. (2014) 11(2), 221–231 ISSN 2044-9038 part of As we move into the fourth decade of the HIV epidemic, this illness, once considered nearly always fatal, is now viewed as a chronic disease in most industrialized nations, due to advances in treatment. Patients with HIV are growing older and the number of infected patients over the age of 50 years is growing steadily. With this shift in demographics, the medical field is turning its attention toward the need to both care for older patients whose disease is long-standing, and identify newly infected older patients. It is increasingly apparent that older HIV-infected patients are vulnerable to a variety of non-AIDS-related conditions and the interplay of aging and HIV occurs in multiple ways. Identifying older patients at risk, the importance of getting patients into care and the impact of aging on the course of the infection are discussed as are common comorbidities such as cardiovascular disease, chronic kidney disease and neurocognitive decline. Recommendations for the evaluation of an older HIV-infected patient are outlined, recognizing that optimizing comprehensive, multidisciplinary care is essential.