What Are The Symptoms Of Hiv
Many people do not notice symptoms when they first acquire HIV. It can take as little as a few weeks for minor, flu-like symptoms to show up, or more than 10 years for more serious symptoms to appear, or any time in between. Signs of early HIV infection include flu-like symptoms such as headache, muscle aches, swollen glands, sore throat, fevers, chills, and sweating, and can also include a rash or mouth ulcers. Symptoms of later-stage HIV or AIDS include swollen glands, lack of energy, loss of appetite, weight loss, chronic or recurrent diarrhea, repeated yeast infections, short-term memory loss, and blotchy lesions on the skin, inside the mouth, eyelids, nose, or genital area.
Immunosenescence And Hiv Infection
Physiological aging of the immune system, termed immune senescence, is associated with a dysfunction in innate and adaptive immunity which diminishes the ability to respond to novel foreign antigensvaccinations and infections. Similar changes in immune functions occur in people with chronic HIV infection but at a much younger age.
Changes seen in adaptive immune system manifest as lower naïve:memory CD4 ratio and enrichment of CD28/CD57+/CD8+ effector T cells. The latter are senescent cells with shorter telomeres and limited proliferative capacity. In addition, there are putative qualitative and quantitative changes in T regulatory cells and a decrease in the diversity of naïve B cells and a qualitative B cell dysfunction.
What The Study Found
The relative risk of eight major non-AIDS diseases fell with increasing age in HIV-positive people compared with HIV-negative people.
The study included 5897 people with HIV matched to 53,073 HIV-negative people in the general population. Median age in both groups stood at 37 years, and three quarters of both groups were men.
Compared with the general-population group, HIV-positive people had a higher relative risk of all age-related diseases studied except for “other cancers.” As expected, the absolute risks of these diseases rose with older age in people with and without HIV. However, the relative risk of all these diseases — except fractures — fell with increasing age in HIV-positive people compared with HIV-negative people . In other words, increasing age did not make age-related diseases more likely in people with HIV.
Falling Relative Risk Of 8 Diseases With Age in HIV-Positive Versus HIV-Negative PeopleFigure 1.
Next the researchers looked at whether absolute risk or relative risk of these nine diseases increased with time since people tested positive for HIV. For these analyses, the researchers used statistical techniques to account for the impact of aging on risks of the nine diseases.
Results were very similar when the researchers calculated absolute risk and relative risk of serious age-related diseases with time since these HIV-positive people started combination antiretroviral therapy.
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Taking Care Of Your Health
Its important to have regular health check-ups and ask your healthcare professional to monitor your blood and urine tests for signs of any problems. If you think youre experiencing any new symptoms or illnesses, or any side-effects to your treatment regime, let your healthcare professional know so they can look into the causes.
You can also reduce your risk of developing these age-related illnesses by:
- not smoking
- limiting your alcohol and drug intake
- keeping your brain active.
Stigma And The Need For Social Support For Older Adults Living With Hiv
The aging process itself can lower energy levels, restrict social encounters, and cause decreased physical and mental abilities. This means that older people living with HIV may suffer more emotional problems and physical stresses than others do.
Stigma can also make things difficult. There is the stigma of living with HIV and the stigma of being older. This can make it difficult for older people to find support. First of all, they may be ashamed and hesitate to tell anyone that they live with HIV. Secondly, they may not be comfortable in support groups that include younger people.
However, it is important for older people living with HIV to seek out support. A lack of support can lead to depression. A mental health counselor, health educator, or peer counselor can help. Some peer counselors may have had similar experiences and can share healthy ways to cope.
You may find it helpful to hear the stories of older people living with HIV of women and men, some of whom have been living with HIV for years, and some of whom have been recently diagnosed with HIV. See the Additional Resources section for links to some stories.
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Impact Of Age Comorbidities And Poverty
Dr. Robbie Goldstein, an infectious disease specialist at Massachusetts General Hospital and director of its Transgender Health Program, said the coronavirus is most likely to affect the HIV-positive population through secondary conditions, such as homelessness, incarceration, old age and underlying health problems.
What I say to my patients is, if you’re taking your medications and your CD4 count is greater than 200, for right now, we believe that it is not your immune system that is going to increase your risk of acquiring COVID, Goldstein said. That said, many of my patients and many patients living with HIV have other issues that they’re facing that put them at really high risk.
How Does Hiv Affect A Person In The Long Term
Though the outlook has gotten much better for those with HIV, there are still some long-term effects that they might experience.
As time passes, people living with HIV may begin to develop certain side effects of treatment or HIV itself.
These may include:
The body may also undergo a shift in how it processes sugars and fats. This can lead to having more fat in certain areas of the body, which can change the bodys shape. However, these physical symptoms are more common with older HIV medications. Newer treatments have far fewer, if any, of these symptoms affecting physical appearance.
If treated poorly or left untreated, HIV infection can develop into stage 3 HIV, or AIDS.
A person develops stage 3 HIV when their immune system is too weak to defend their body against infections. A healthcare provider will likely diagnose stage 3 HIV if the number of certain white blood cells in an HIV-positive persons immune system drops below 200 cells per mL of blood.
Life expectancy is different for every person living with stage 3 HIV. Some people may die within months of this diagnosis, but the majority can live fairly healthy lives with regular antiretroviral therapy.
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Why Should People Living With Hiv Be Concerned About Cvd
In the first two decades of the HIV epidemic the biomedical focus was to prevent and treat life-threatening infections. However, now that effective antiretroviral therapy is widely available in high-income countries, deaths from life-threatening infections are uncommon. As a result, HIV-positive people are living longer. As they get older, people with HIV become vulnerable to all the complications brought on by ageingthis includes CVD.
In addition to this, ongoing HIV infection, particularly if left untreated, can increase the risk of CVD. This happens because the ongoing replication of HIV in your body causes your immune system to be in a continuous state of high-level inflammation. Over the long-term, continuous inflammation releases chemical messengers called cytokines that harm the body, damaging and degrading tissues.
Not only does HIV-related inflammation injure the immune system and other organ-systems, it also accelerates the ageing of blood vessels. The use of ART greatly decreases HIV-related inflammation. Indeed, studies have found that people who stop taking ART have a greatly increased risk for heart attacks and stroke. However, even in the setting of low or undetectable viral load, low-level inflammation triggered by HIV infection may continue to slowly affect organs and blood vessels, but at a much lower level than before. Over the long-term, this inflammation may heighten the risk for CVD in HIV-positive people.
Plan For The Long Term
You may need to reconsider how you’re thinking about your future. “I talk to people with HIV who say, ‘I didn’t expect to live to middle age, but now I’m middle-aged and I’m probably going to live another 30 years,'” Hare says. This adjustment can be a challenge.
Perhaps you haven’t saved enough money to last for a longer life. That’s something a financial planner can help you sort out.
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What Else Can You Do
While these health challenges may seem discouraging, they show that the lives of people living with HIV are now long and healthy enough that they die of the same conditions as the general population. Because people living with HIV may encounter these medical issues earlier in their lives, it is important that both people living with HIV and their providers are aware of them. There is still plenty you can do to stay healthy and live a full life. Here are some suggestions to get you started:
How Is Hiv Treated
Treatments for HIV typically involve antiretroviral therapy. This isnt a specific regimen, but instead a combination of three or four drugs. The U.S. Food and Drug Administration has currently approved nearly 50 different medications to treat HIV.
Antiretroviral therapy works to prevent the virus from copying itself. This maintains immunity levels while slowing the progression of HIV.
Before prescribing medication, a healthcare provider will take the following factors into consideration:
- a persons health history
- the levels of the virus in the blood
HIV doesnt cause a lot of outward or noticeable symptoms until the disease has progressed. For this reason, its important to understand how HIV is transmitted and the ways to prevent transmission.
HIV can be transmitted by:
- having sex, including oral, vaginal, and anal sex
- sharing needles, including tattoo needles, needles used for body piercing, and needles used for injecting drugs
- coming into contact with body fluids, such as semen, vaginal fluid, blood, and breast milk
HIV is not transmitted by:
- breathing the same air as a person living with HIV
- getting bitten by a mosquito or other biting insect
- hugging, holding hands with, kissing, or touching a person living with HIV
- touching a door handle or toilet seat thats been used by an HIV-positive person
Keeping this in mind, some of the ways a person can prevent HIV include:
Symptoms can take years to appear, which is why its so important to get tested regularly.
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Is It Safe For Children With Hiv To Receive Routine Immunizations
MMR, or measles, mumps, and rubella vaccine, is safe to give to children with HIV, unless they have a severely weakened immune system.
DTaP/Td vaccine is safe to give to infants and children with HIV.
Hib and Hep B vaccines are safe to give to children with HIV.
Hepatitis A and B vaccines are safe to give to HIV-positive children.
VZIG should be considered for known HIV-positive children, depending on their immune status.
A yearly influenza vaccine is recommended for children with HIV, as well as any individual living in the same household as a child with HIV. There are two types of influenza vaccine children and adults with HIV should receive the “shot” form of the vaccine–not the nasal spray form, as it contains a live virus. Pneumococcal vaccine can be safely administered to age-appropriate HIV-infected children.
Always consult with your child’s doctor regarding immunizations for an HIV-infected child.
Treating The Rash At Home
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Metabolic And Physiologic Changes Occur With Age
The genetic basis of ageing is complex and no single gene or set of genes has clearly been linked to normal human ageing across the population . Numerous studies have identified metabolic and physiologic changes that occur with age. Creatinine clearance declines by approximately 30% between the ages of 30 and 80 . Similarly, cardio-respiratory fitness, as measured physiologically and expressed in metabolic equivalents, declines by around 40% from age 30 to 80 . Bone mass also declines progressively with age, at a similar rate in men and women, but men take longer to reach a fracture threshold due to starting with a higher bone mass .
A Few More Ounces Of Prevention
We should not short-change other interventions that help people stay healthy as they age. These include basic things, like vaccinations. Many people dont get the influenza vaccine, believing it will make them sickplacing themselves and others, including children, at risk for this potentially devastating infection. The flu shot cannot cause the flu . We should all get it every year. Other important vaccines include those for strep pneumonia and shingles.
Other no-brainers when it comes to aging well with HIV include good recordkeeping of all medications, even over-the-counter and alternative ones. Bring a list of all your drugs and supplements to the clinic to help your health care providers avoid drug interactions or errors that could be harmful.
Older people also have sex, thank goodness, and no one should age out of asking about and being screened for sexually transmitted infections.
Lastly, depression is highly prevalent among people with HIV, as well as older folks. This needs to be looked for and addressed. Besides medicine, social support can help and is critical to well-being.
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Chronological Ageing And Biological Ageing
Ageing is defined as a time-dependent decline of functional capacity and stress resistance, associated with anincreased risk of disability, morbidity or mortality. Its rate cansignificantly differ from one person to another, depending on many factors,from the genetic to the environmental. Chronological age may therefore not bethe best way to measure ageing.
Could biomarkers that reflect age-related changes inbody function or composition measure this process more accurately and be usedto predict the onset of age-related diseases? In other words, could ameasurement of biological age” be more reliable than chronological age?
Nbc Outhow To Survive A Pandemic: Hiv Experts And Activists On Lessons Learned
Echoing the CDCs guidance, Goldstein said its important for those living with HIV to establish a strong virtual support network to combat loneliness as they self-isolate during the mitigation phase of the pandemic. Barnes stressed the importance of keeping up with ones health status in terms of HIV and beyond.
Because you know, somebody who’s diabetic and doesn’t know it is also immune compromised, Barnes said.
Johnson, a longtime HIV activist who has lived with the virus for over a decade, said he sees a silver lining for people living with HIV and other chronic conditions, who are accustomed to navigating health care obstacles.
I’m incredibly resilient, and I think that that applies to many people living with HIV, he said. Were actually better prepared than a lot of people to deal with this current reality.
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Taking Hiv Treatment Long
People living with HIV who have been taking ART since the early 1990s may now be experiencing long-term effects of the treatment. For example, some drugs can increase cholesterol, and put additional strain on the liver and kidneys.
As you age, and experience other health issues, its likely that youll be advised to take more medication. You may see one healthcare professional for HIV treatment and another for something else.In some cases, medication for another condition can interact with your HIV drugs, making one or both of them less effective. Its important that your healthcare professionals know about the drugs you are taking, including any herbal remedies and alternative treatments.
The Aging Hiv Population Is Growing
Around the world, 4.2 million people over the age of 50 13% of all people living with HIV are living with the virus, UNAIDS estimates. In 2016, eight of ten older people living with HIV globally were in low- and middle-income countries. In the US, more than half of those living with HIV who know their diagnosis were at least 50 years old in 2018.
In the US, HIV began mostly as a disease of young men. Today, however, the epidemic affects both women and men of all ages, including older women. While 50 may not seem ‘old,’ it is often the age used by organizations that keep track of health-related statistics. As a result, issues related to getting and being older with HIV are receiving more and more attention.
The number of older people living with HIV is growing for two main reasons: 1) powerful HIV drugs are allowing many people to lead longer, healthier lives with HIV and 2) while most new HIV cases occur in younger people, people over 50 are acquiring HIV at increasing rates. To find out more about why more older adults are acquiring HIV, see our fact sheet on Older Women: At Risk for HIV.
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