Thomas Ashmitha, Hoy Jennifer F
Department of Infectious Diseases, Alfred Hospital, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.
Department of Infectious Diseases, School of Translational Medicine, Monash University, Melbourne, Australia.
Curr HIV/AIDS Rep. 2024 Dec 12;22(1):8. doi: 10.1007/s11904-024-00718-9.
Potent, well tolerated and simple to administer antiretroviral therapy (ART) has resulted in significant improvement in life expectancy for people with HIV. The increased lifespan does not necessarily equate to improved healthspan with increased rates of comorbidities, frailty and geriatric syndrome experienced by older people with HIV. This review explores the challenges in prevention and management of multimorbidity and geriatric syndrome with the ultimate goal of improving health and quality of life through holistic care.
Recent studies have drawn attention to the multifactorial nature of most comorbidities experienced by people with HIV. Adverse effects of contemporary ART, combined with lifestyle factors of smoking, excess alcohol and other substance use, chronic immune activation and inflammation associated with chronic HIV infection and other co-infections, all impact multimorbidity and geriatric syndromes. The complex healthcare needs of the aging population of people with HIV will require comprehensive, multidisciplinary integrated models of care.
强效、耐受性良好且易于给药的抗逆转录病毒疗法(ART)已使HIV感染者的预期寿命显著提高。寿命延长并不一定等同于健康寿命的改善,因为老年HIV感染者的合并症、虚弱和老年综合征发生率有所增加。本综述探讨了预防和管理多重疾病和老年综合征方面的挑战,其最终目标是通过整体护理改善健康和生活质量。
最近的研究已将人们的注意力引向HIV感染者所患大多数合并症的多因素性质。当代ART的不良反应,再加上吸烟、过量饮酒和其他物质使用等生活方式因素、与慢性HIV感染及其他合并感染相关的慢性免疫激活和炎症,均会影响多重疾病和老年综合征。老年HIV感染者复杂的医疗保健需求将需要全面、多学科的综合护理模式。