Ahmed Mohamed H, Ahmed Fatima, Abu-Median Abu-Bakr, Panourgia Maria, Owles Henry, Ochieng Bertha, Ahamed Hassan, Wale Jane, Dietsch Benjamin, Mital Dushyant
Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK.
Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK.
Microorganisms. 2023 Sep 28;11(10):2426. doi: 10.3390/microorganisms11102426.
The continuing increase in patient numbers and improvement in healthcare provisions of HIV services in the UK, alongside the effectiveness of combined antiretroviral therapy (cART), has resulted in increasing numbers of the ageing population among people living with HIV (PLWH). It is expected that geriatricians will need to deal with many older people living with HIV (OPLWH) as life expectancy increases. Therefore, geriatric syndromes in OPLWH will be similar to the normal population, such as falls, cognitive decline, frailty, dementia, hypertension, diabetes and polypharmacy. The increase in the long-term use of cART, diabetes, dyslipidaemia and hypertension may lead to high prevalence of cardiovascular disease (CVD). The treatment of such conditions may lead to polypharmacy and may increase the risk of cART drug-drug interactions. In addition, the risk of developing infection and cancer is high. OPLWH may develop an early onset of low bone mineral density (BMD), osteoporosis and fractures. In this review, we have also provided potential psychosocial aspects of an ageing population with HIV, addressing issues such as depression, stigma, isolation and the need for comprehensive medical and psychosocial care through an interdisciplinary team in a hospital or community setting. OPLWH have a relatively high burden of physical, psychological, and spiritual needs and social difficulties, which require palliative care. The holistic type of palliative care that will improve physical, emotional and psychological wellbeing is discussed in this review.
在英国，艾滋病患者数量持续增加，艾滋病服务的医疗保健条件不断改善，同时联合抗逆转录病毒疗法（cART）效果显著，导致感染艾滋病病毒的人群（PLWH）中老龄人口数量不断增加。随着预期寿命的延长，预计老年病医生将需要应对许多老年艾滋病患者（OPLWH）。因此，老年艾滋病患者的老年综合征将与正常人群相似，如跌倒、认知能力下降、身体虚弱、痴呆、高血压、糖尿病和多重用药。长期使用cART、糖尿病、血脂异常和高血压的增加可能导致心血管疾病（CVD）的高患病率。治疗这些疾病可能导致多重用药，并可能增加cART药物相互作用的风险。此外，感染和患癌风险很高。老年艾滋病患者可能会较早出现低骨矿物质密度（BMD）、骨质疏松症和骨折。在这篇综述中，我们还探讨了感染艾滋病病毒的老龄人口潜在的社会心理问题，通过医院或社区环境中的跨学科团队解决诸如抑郁症、耻辱感、孤独感以及对全面医疗和社会心理护理的需求等问题。老年艾滋病患者在身体、心理和精神需求以及社会困难方面负担相对较重，这需要姑息治疗。本综述讨论了能改善身体、情感和心理健康的整体姑息治疗类型。
