Archive for July 23, 2011

Aging and HIV infection.

Ageing Res Rev. 2011 Jan V.10 N.1 P.163-72..

Avelino-Silva VI, Ho YL, Avelino-Silva TJ, Santos Sde S.

Infectious and Parasitic Diseases Division, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo – Avenida Dr. Eneas de Carvalho Aguiar 255, 4° Andar do Instituto Central, Sala 4028 – 05403-000-Sao Paulo, SP, Brazil.



Population aging has become a global phenomenon, and HIV infection among older individuals is also increasing. Because age can affect the progression of HIV infection, we aimed to evaluate the present knowledge on HIV infection in older patients.


Literature review of the last 20 years.


Older HIV-infected patients have lower CD4(+) T cell counts, higher viral load and are more frequently symptomatic at diagnosis. The infection progresses more rapidly, with higher morbidity and lethality rates. However, older patients are more compliant to antiretroviral treatment; they experience a better virologic response, and treatment represents a positive clinical impact. Aging affects the complex interaction between HIV infection and the immune system. Both conditions contribute to the dysfunction of immune cells, including a decrease in the phagocytes’ microbicidal capability, natural killer cells’ cytolytic function, expression of toll-like receptors and production of interleukin-12. Chronic immune activation responsible for the depletion of CD4(+) and CD8(+) T cells in HIV infection appears to worsen with senescence. Older patients also exhibit a less robust humoral response, with the production of less avid and specific antibodies.


Both HIV and aging contribute to immune dysfunction, morbidity and mortality. However, highly active antiretroviral therapy (HAART) is beneficial for older patients, and treatment of older patients should not be discouraged.



July 23, 2011 at 6:29 pm Leave a comment

Growing Old with HIV

Curr Infect Dis Rep. 2011 Feb;13(1):75-82.

Patel D, Crane LR.

Department of Medicine, Division of Infectious Diseases, Wayne State University School of Medicine, c/o Harper University Hospital, 3990 John R Street, Room 5929 Hudson, Detroit, MI, 48201, USA,


The intersection of chronic HIV infection, its treatment, and lifestyle with aging has become a topic of considerable fascination during this, the third decade of the AIDS epidemic. An understanding of the pathophysiology of this intersection may provide valuable insights into our general understanding of human aging. This review summarizes the results of recent publications that may have considerable impact on screening and management strategies in the aging HIV-infected population.


July 23, 2011 at 6:25 pm Leave a comment

HIV infection, inflammation, immunosenescence, and aging.

Annu Rev Med. 2011 Feb 18;62:141-55.

Deeks SG.

Department of Medicine, San Francisco General Hospital, University of California San Francisco, CA, USA.


Although antiretroviral therapy for HIV infection prevents AIDS-related complications and prolongs life, it does not fully restore health. Long-term treated patients remain at higher than expected risk for a number of complications typically associated with aging, including cardiovascular disease, cancer, osteoporosis, and other end-organ diseases. The potential effect of HIV on health is perhaps most clearly exhibited by a number of immunologic abnormalities that persist despite effective suppression of HIV replication. These changes are consistent with some of the changes to the adaptive immune system that are seen in the very old (“immunosenescence”) and that are likely related in part to persistent inflammation. HIV-associated inflammation and immunosenescence have been implicated as causally related to the premature onset of other end-organ diseases. Novel therapeutic strategies aimed at preventing or reversing these immunologic defects may be necessary if HIV-infected patients are to achieve normal life span.




July 23, 2011 at 6:22 pm Leave a comment


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