Growing Older With Hiv
Today, thanks to improvements in the effectiveness of treatment with HIV medicine , people with HIV who are diagnosed early and who get and stay on ART can keep the virus suppressed and live long and healthy lives. For this reason, nearly half of people living with diagnosed HIV in the United States are aged 50 and older. Many of them have been living with HIV for many years others were diagnosed with HIV later in life.
Thats a significant change from the early years of the epidemic when people who were diagnosed with HIV or AIDS could expect to live only 1-2 years after their diagnosis. This meant that the issues of aging were not a major focus for people with HIV disease.
According to the Centers for Disease Control and Prevention , in 2018, over half of people in the United States and dependent areas with diagnosed HIV were aged 50 and older. In addition, people aged 50 and older accounted for 17% of the 37,968 new HIV diagnoses in 2018 in the United States and dependent areas. Though new HIV diagnoses are declining among people aged 50 and older, around 1 in 6 HIV diagnoses in 2018 were in this group.
People over age 50 with HIV make up 46.8% of the over half a million clients served by the Ryan White HIV/AIDS Program . In 2019, 92.2% of clients aged 50 and older receiving RWHAP HIV medical care were virally suppressed, which was higher than the national RWHAP average .
Dental Health: What Are The Long Term Effects Of Hiv
What are the long term effects of HIV on a patients body? Is there any effect of HIV on the dental health of a person suffering from the virus? This article will talk about the impact of HIV and how having an infection can affect dental health. After reading the article, you can check out go to Dentistry on Solents clinic in Bella Vista for all your dental care needs.
How Do Hiv/aids Medicines Work
HIV/AIDS medicines reduce the amount of HIV in your body, which helps by:
- Giving your immune system a chance to recover. Even though there is still some HIV in your body, your immune system should be strong enough to fight off infections and certain HIV-related cancers.
- Reducing the risk that you will spread HIV to others
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Clinical Research And Drug Regulation
In perhaps no other area has the impact of the HIV/AIDS epidemic been more clear than in the identification, clinical testing, and regulation of new drugs and in the conduct of clinical research. The most profound change wrought by AIDS in drug development is simply the dramatic increase in public awareness of the nature, structure, and purpose of clinical trials. Debate about the ethics and scientific validity of clinical trials occurs not only among physicians, statisticians, and ethicists, but also among patients, activists, and politicians. AIDS has to a large degree publicized and politicized the aspects of clinical investigation that were heretofore largely within the private purview of the scientific community.
Although it is impossible at this time in the epidemic to reach any definitive conclusions about the impact of AIDS on clinical research and the regulation of new drugs, it is apparent that patient activism and the exigencies of the AIDS epidemic have generated the most significant reevaluation of the research and regulation process to occur since World War II.
How Is Hiv Diagnosed
An HIV antibody test, either from a blood sample or an oral sample , can tell whether you have been infected. A negative test result means no HIV antibodies were found. This usually means you are not infected. However, if you engaged in behavior that could spread the virus within three months of having the test, antibodies may not be detectable and you should be re-tested. A positive test result means antibodies to HIV were found. This means you are infected with the virus and can pass HIV to others even if you have no symptoms. You are infected for life. Even if you think you have a low risk for HIV infection, consider getting tested whenever you have a regular medical check-up.
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How Has Treatment Improved
Antiretroviral medications can help to slow damage caused by HIV infection and prevent it from developing into stage 3 HIV, or AIDS.
A healthcare provider will recommend undergoing antiretroviral therapy. This treatment requires taking three or more antiretroviral medications daily. The combination helps suppress the amount of HIV in the body . Pills that combine multiple medications are available.
The different classes of antiretroviral drugs include:
- non-nucleoside reverse transcriptase inhibitors
- integrase inhibitors
Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing stage 3 HIV. The other benefit of an undetectable viral load is that it helps reduce transmission of HIV.
The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means that the viral load is below 50 copies per milliliter .
This discovery has led to an HIV prevention strategy known as treatment as prevention. It promotes constant and consistent treatment as a way to reduce the spread of the virus.
HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Initial reports from a clinical trial in the United Kingdom and a from the United States showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.
Figuring Out The Cause Of What You Are Feeling
Always seek a full diagnosis from your doctor regarding all symptoms. What youre feeling could be from your medication, but it could also be a hormone problem, a nutrient deficiency, an infection, depression, HIV infection itself or something else.
Determining what could be contributing to a given side effect can be difficult, and an obvious place to start is by discussing the problem with your doctor. Doctors who have worked with many people living with HIV are usually familiar with the majority of likely drug side effects.
You can also look at the information available on a particular drug. The product monograph or prescribing information for a drug the official, approved document that summarizes what is known about it will normally contain a fairly comprehensive list of all known side effects. In some cases, these lists can be very long and seem to include every possible side effect known. However, if you see a symptom you are experiencing listed as one of the common side effects, this is a hint your drug could be the cause.
Two other things are important to remember. First, it is always possible that you could be the first patient to ever experience a particular side effect. This isnt likely, but it is possible. The fact you dont see a side effect listed does not mean it is impossible the drug is causing this problem in you.
In each section of this guide, we discuss the possible contributing causes of symptoms to help you untangle whats causing what.
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Taking Control Of Side
If you do experience side-effects of anti-HIV drugs, it is good to know that something can nearly always be done about them. There are also some things you can do to reduce the risk of side-effects or make them less severe if you do experience them.
- Tell your doctor about other medications you are taking. This includes prescription, over-the-counter, herbal or recreational drugs. Some side-effects can be caused by interactions between several different drugs. It is also important to tell your doctor about any allergies you have to medications and other health conditions.
- Look after yourself. Eat a healthy, balanced diet make sure you get enough sleep try to give up smoking exercise regularly and cut back on alcohol and recreational drugs.
- Report side-effects to your doctor. It is very important to talk to your doctor about any side-effects or symptoms you experience, even if you are not sure whether the drugs you are taking are the cause. It can often help to make some notes about your symptoms before your appointment, for example when the symptoms started and any pattern you have noticed. It is especially important to report a side-effect if it means you are less likely to take your HIV treatment in the right way and at the right time .
Tracking How Youre Feeling
You must be in touch with your body so youre clear on what you are experiencing and can describe it to your doctor. This leads us to the two most important rules:
Rule #1: Tell your doctor everything, from beginning to end. If a symptom appears, changes, disappears or reappears, tell your doctor whats up. Write it down so you do not forget.
Rule #2: Always apply Rule #1.
It can be helpful to keep a symptom diary so you can show your doctor a record of everything you have been experiencing. Keeping a daily record as you experience symptoms is better than trying to remember them later.
We have included here My Health Map, which is a simple way to track what youre feeling by drawing on a silhouette of a body and answering a few questions. Photocopy the map and use it to keep track of your symptoms over time. Or use a personal health record, which you can use to record many aspects of your HIV care.
The key things to report to your doctor about any given symptom are these:
Frequency: How often do you experience it? Is it something you only notice a couple of times a month? Multiple times every day? All day, every day?
Intensity: Is this a minor problem or something severe? If you rank it on a scale from one to five, where does it fall? If the intensity varies, noting this in detail with each occurrence can be part of the daily record you keep.
Treatment: Is there anything you have found that helps?
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Neurological Complications Of Hiv
HIV is the virus that causes AIDS. HIV weakens and slowly destroys the bodys immune system, leaving you vulnerable to life-threatening complications from an infection or certain cancers.
As HIV and AIDS battle your immune system, your central nervous system is also affected. HIV and AIDS both cause a number of neurological complications, particularly if HIV progresses to AIDS.
Today, antiretroviral medicineswhen taken correctly and promptlyhelp to slow down the progression of HIV. They also help to delay the onset of or to decrease the risk of progression to AIDS. Controlling HIV can also reduce your risk for neurological complications of HIV.
Managing Hiv Alongside Other Conditions
Thanks to advances in HIV treatment and care, HIV life expectancy has improved exponentially. Were now seeing the first generation of people living with HIV entering later life and accessing later life care.7
As we all get older, regardless of HIV status, our health gets more complicated. People living with HIV can develop the same age-related conditions that affect everyone such as heart disease, kidney disease, liver disease or diabetes. Living with a chronic condition like HIV, also increases the risk of developing other health conditions and certain cancers.2,8
Co-ordinating your care and balancing the medications for these conditions alongside your existing HIV treatment is an essential factor in maintaining a high quality of life as we age.9
Keeping your doctor up to date
Here, Xiana talks about the importance of telling her doctor about her healthcare needs as they evolve over time.
A World of Difference
In this clip from the Positively thriving podcast Tom, Brad and Bryan talk about long-term health, ageing well with HIV, and the benefits of being completely open with your healthcare team.
Listen to the full episode ofPositively Thriving: A World of Difference
HIV & other conditions
There are some health conditions that people living with HIV have a higher risk of developing. Even common illnesses can be more serious for people living with HIV they can get worse faster than they normally would.
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Facts About Hiv: Life Expectancy And Long
The outlook for people living with HIV has significantly improved over the past two decades. Many people who are HIV-positive can now live much longer, healthier lives when regularly taking antiretroviral treatment.
Kaiser Permanente researchers found that the life expectancy for people living with HIV and receiving treatment increased significantly from 1996 on. Since that year, new antiretroviral drugs have been developed and added to the existing antiretroviral therapy. This has resulted in a highly effective HIV treatment regimen.
In 1996, the total life expectancy for a 20-year-old person with HIV was 39 years. In 2011, the total life expectancy bumped up to about 70 years.
The survival rate for HIV-positive people has also dramatically improved since the first days of the HIV epidemic. For example,
, a person with undetectable levels of HIV in their blood isnt able to transmit the virus to a partner during sex.
Between 2010 and 2014, the annual number of new HIV infections in the United States fell by
Does Prep Have Risks
People with HIV have used Truvada, tenofovir and emtricitabine, for several years. They are generally easy to take. Possible long-term side effects include loss of bone mineral density and kidney damage.
Some people worry that people taking PrEP might think they are totally protected. They might be less careful about their sexual behavior. So far, this does not appear to be true.
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What Should I Do If I Notice Side Effects
It is important to take your medicine every day. If you are having a hard time doing this, let your doctor know. If you are worried about a side effect, keep taking your medicine until you discuss your concern with your doctor. Eat a healthy diet, exercise, and take a multivitamin every day.
If you have diabetes or cholesterol problems, talk to your doctor about whether you should make any changes in your diet. Your doctor will also give you medicine for these conditions. Tell your doctor at each visit all of the medicines you are taking, including herbal medicines.
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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Daily Pattern To Side
There can be a daily pattern to side-effects, linked to the time you take your medicines and also to the processing of the drug by your body. It might be possible to minimise the inconvenience that this causes by adjusting the time at which you take your medicines. For example, efavirenz can cause dizziness and other psychological side-effects. Many people overcome these by taking their daily dose of the drug just before going to bed.
“Your doctor can usually do something about side-effects, so it makes good sense to mention any that youre experiencing.
Clinical Guidelines For Hiv Treatment: Strategies That Optimize Success
Andrew R. Zolopa, MD
The International AIDS Society -USA Panel hasrecently updated their recommendations.4 According to theseguidelines, ART should be initiated in asymptomatic patients withCD4+ cell counts < 500 cells/mm3. Furthermore, ART should beconsidered in patients with CD4+ cells counts > 500cells/mm3, unless the patient is an elite controller or has stable CD4+ cell counts and low-level viremiain the absence of ART. There are also specific conditions for which ART isrecommended regardless of CD4+ cell count. Like the DHHS guidelines,IAS-USA guidelines recommend that ART is initiated in pregnant women, patientswith hepatitis B co-infection, and patients with HIVAN. However, IAS-USArecommends the initiation of therapy in patients with other conditions, such ashepatitis C co-infection, levels of HIV-1 RNA > 100,000 copies/mL, rapiddecline in CD4+ cell count ,and high risk for secondary HIV transmission .Furthermore, the IAS-USA recommendations indicate that ART should be initiatedin patients with cardiovascular disease or who are at significant riskfor CVD, which may seem counterintuitive given the association of ART with CVDrisk. However, HIV is coming to be recognized as an important contributor toCVD-associated morbidity and mortality, which will be discussed later in thismonograph.
Rationale for Initiating Therapy Earlier
There are several studies which support the rationalefor initiating ART as early as possible.
IAS-USA 2010: Guidelines for Initial ART Regimens
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