Unit of Infectious Diseases, Department of Medical Sciences, University of Torino, Torino, Italy.
Department of Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy.
Infection. 2015 Oct;43(5):509-22. doi: 10.1007/s15010-015-0795-5. Epub 2015 May 19.
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.
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.
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.
随着高效抗逆转录病毒治疗的引入，HIV 感染的病程转变为慢性疾病，大多数 HIV 阳性患者很快将超过 50 岁。
本文综述了医生在照顾 HIV 阳性老年患者时需要面对的多个方面，包括虚弱的定义以及合并症的患病率和危险因素。从治疗的角度来看，讨论了与衰老相关的药代动力学变化和抗逆转录病毒药物的特异性毒性；最后，综述了 HIV 阳性和阴性患者虚弱的治疗方法。
我们的结论是，联合使用毒性最小的药物和促进健康行为（包括适当的营养和运动）可能是 HIV 阳性老年患者的最佳治疗方法。
