Hiv/aids In The Elderly

From Anvita Health Wiki

Contents 1 Epidemiology 2 Pathology 3 Complications 4 Management 5 More General Terms 6 Additional Terms 7 References

Epidemiology

• 10% of AIDS diagnosis in patients > 50 years (1999)
• 10-fold increase in AIDS in patients > 65 years of age in decade of 1990-2000
• persons most likely to have risky behavior are married men 50-60 years of age

Pathology

• comorbidities contribute to liklihood of AIDs at presentation
• HIV1 progresses faster in the elderly [2]

Complications

• depression (65%)
• AIDS dementia (40%)
• multiple comorbid illness (40% with > 2 comorbid conditions)

• drug-induced hepatitis, hyperlipidemia, peripheral vascular disease, lung cancer, coronary artery disease, peripheral neuropathy, stroke

• older women likely to have:

• psychosocial illness, depression, anxiety, substance abuse, psychosis

Management

• adults > 50 & < 50 years of age respond equally well to antiretroviral therapy
• adults > 50 generally sustain 1/2 the rise in CD4 count in response to antiretroviral therapy

• 2 phase response of CD4 count
• 4 weeks: return of memory CD4 cells, not different in patients > 50 years
• 24 weeks: formation of naive CD4 cells, diminished in patients > 50 years

• hormone replacement therapy in women associated with increased survival

More General Terms

• geriatrics
• Acquired Immuno-Deficiency Syndrome (AIDS)
• human immunodeficiency virus-1

Additional Terms

• age-associated changes in immunity
• elderly (senior citizen)
• human immunodeficiency virus-1

References

1. Ardos Moe MD, UCLA Multicampus Program in Geriatric/Gerontology, Lecture series, 02/15/2002
2. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
3. HIV, AIDS, and Older People [1]

HIV/AIDS in the elderly