HIV Long-Term Survivors Awareness Day: Patients ‘deserve our respect and support’

Paul A. Volberding

Today is HIV Long-Term Survivors Awareness Day, which is observed each year on June 5 to honor the patients who survived the early HIV/AIDS epidemic but now face new health issues.

The date marks the anniversary of an MMWR published on June 5, 1981 that described five cases of Pneumocystis pneumonia among previously healthy young men who have sex with men in Los Angeles. It would later become the first official reporting of the AIDS epidemic, according to HIV.gov.

Since the start of the epidemic, HIV has infected more than 70 million people worldwide, costing approximately 35 million lives, according to WHO. In 2016, an estimated 36.7 million people were living with the virus, and 1 million people died from HIV-related illnesses.

Despite the continued burden of HIV, it is now considered a chronic, manageable disease in regions with accessible ART, thanks to advances in diagnosis, treatment and prevention. As a result, people with HIV are living longer. The CDC estimates that patients aged 50 years and older represent almost half of the HIV population in the United States.

“We are, of course, delighted to have many who are now living for many years despite being HIV-infected. This reflects a stunningly effective history of developing potent and well-tolerated medications that suppress HIV replication,” Infectious Disease News Chief Medical Editor Paul A. Volberding, MD, director of the Center for AIDS Research and professor at the University of California, San Francisco, said in an interview. “But that great development should not blind us to the very real challenges many long-term survivors are experiencing. Comorbidities such as cardiovascular disease are more common, patients are experiencing diseases normally associated with aging, and many are dealing with depression and loneliness given the many friends and partners lost to the earlier epidemic. The needs of these brave people living with HIV infection deserve our respect and support.”

In honor of HIV Long-term Survivors Awareness Day, Infectious Disease News has compiled a list of the top 10 stories about the often-overlooked aging HIV population:

Q&A: Treating older adults with HIV

Mark Brennan-Ing, PhD, director for research and evaluation at the AIDS Community Research Initiative, or ACRIA, discusses the challenges of treating and preventing HIV in an aging population and how to overcome them. Read more.

One in six new HIV infections diagnosed in patients over 50

People aged 50 years or older accounted for nearly one of every six, or about 17%, of new HIV diagnoses in Europe in 2015, according to study findings in The Lancet HIV. Read more.

Disabilities common in older patients with HIV

Disabilities relating to daily tasks and household activities are common among middle-aged and older adults with HIV who are receiving effective ART, study data showed.

“Multiple studies in the current ART treatment era indicate that older, HIV–infected adults are at increased risk of both frailty and disability,” Kristine M. Erlandson, MD, assistant professor in the division of infectious diseases at the University of Colorado-Anschutz Medical Campus, and colleagues wrote in Clinical Infectious Diseases. “The identification of factors that contribute to disability, particularly if modifiable, can inform development of interventions to prevent or limit disability in the vulnerable population of older, HIV–infected adults and ultimately improve quality of life.” Read more.

1 in 8 patients with HIV has undiagnosed hypertension

Study data show that one in eight patients receiving care for HIV in the United States has undiagnosed and untreated hypertension.

In a nationally representative cohort of 8,631 patients with HIV, 42.4% (95% CI, 40.4-44.5) of PLWH had hypertension. Of those, 13.3% (95% CI, 11.7-14.9) were undiagnosed and untreated. Read more.

Stigma due to age may impact HIV care in older adults

Although older adults at least 50 years of age account for almost half of all people living with HIV and represent 17% of new infections in developed countries, a presentation at the 125th Annual Convention of the American Psychological Association suggests that this population is often overlooked when it comes to HIV prevention and treatment.

One expert said that prejudice and discrimination against older adults, known as ageism, contributes to this neglect. Read more.

INTREPID results support Livalo as optimal treatment for HIV patients with dyslipidemia

Researchers estimate that the risk for myocardial infarction is 1.5 to 2 times higher in people living with HIV compared with uninfected individuals. In addition, dyslipidemia has been reported in up to 80% of patients with HIV.

Although statin therapy is typically recommended for the condition, it has been a challenge to implement in this population because of adverse drug interactions with ART, which can sometimes lead to intolerance or reduced efficacy. New data from the INTREPID trial, however, demonstrated that Livalo (pitavastatin, Kowa), a relatively new statin, resulted in greater reductions in LDL cholesterol, inflammation and other potential contributors to cardiovascular disease, compared with Pravachol (pravastatin, Bristol-Myers Squibb) in HIV–infected patients with dyslipidemia. Read more.

Menopause worsens fatigue, muscle aches in women with HIV

Researchers at Columbia University found evidence that fatigue and muscle aches — two of the most common symptoms among patients with HIV — are exacerbated by menopause. Read more.

Hypertension increases among HIV patients from 1996-2013

An analysis of hypertension rates suggested that incidence among HIV patients has more than tripled from 1996 through 2013 and are accompanied by an increase in several hypertension risk determinants such as obesity or diabetes. Read more.

Advances in HIV treatment uncover a new issue: Aging

Infectious Disease News spoke with several experts about how the issues associated with aging affect patients with HIV and whether HIV makes the aging process more complicated compared with the general population. Read more.

EACS updates HIV guidelines for adults

At last year’s European AIDS Conference, the European AIDS Clinical Society presented its updated guidelines, which include detailed recommendations on ART, as well as diagnosis, monitoring and treatment of comorbidities, coinfections and opportunistic diseases in adults with HIV in Europe. Read more.

Disclosure: Volberding reports no relevant financial disclosures.