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In years and decades past, the greatest health threat to HIV patients was AIDS (autoimmune deficiency syndrome). AIDS occurs after the immune system has been badly damaged by HIV infection, leaving the body unable to fight off opportunistic infections and diseases. In the past, AIDS was the expected outcome after having HIV for 10 years, and once a person developed AIDS, they had a life expectancy averaging less than two years.
Today, the prognosis for people with HIV is much, much better. With treatment, HIV patients are able to have near-normal lifespans. However, as they live longer lives, HIV patients face another health challenge—age-associated disease.
Aging-associated disease
Advancing age is a risk factor many diseases. Common age-associated diseases include cardiovascular disease, osteoporosis, type 2 diabetes, kidney disease, liver disease, and degenerative neurologic disorders (such as dementia). A person’s risk for having these diseases increases as they get older (though it is important to keep in mind that age is only one risk factor for these conditions).
While everyone’s risk of these conditions increases as they age, people who are managing HIV are at an even higher risk. People with HIV may also develop age-associated diseases at younger ages.
HIV and inflammation
The earlier appearance of age-associated diseases in people with HIV appears to be linked to elevated levels of inflammation that are associated with having HIV. The standard for treating HIV is antiretroviral therapy (ART), which works by disrupting different mechanisms in HIV’s lifecycle and blocking the virus’s ability to replicate. This lowers the viral load (the amount of HIV in the body) to very low levels, allowing the immune system to recover and function. While these treatments keep the virus under control, HIV remains a constant presence in the body, one that can trigger a constant, low-grade inflammatory response from the immune system.
Other factors
Inflammation caused by HIV may not be the only contributing factor. Other possible factors may be the long-term use of HIV treatments, having other health conditions in addition to HIV (such as hepatitis C), interactions with other medications for other medical conditions, and the use of alcohol, tobacco, and drugs.
What you can do
It’s important to remember that living with HIV may put you at an increased risk for age-associated diseases like the ones listed above, but there is much you can do to prevent heart disease, type 2 diabetes, liver disease, and osteoporosis. Diet, exercise, and lifestyle play important roles in the prevention of age-associated diseases. Eat a heart-healthy diet, exercise regularly, and nix harmful habits like cigarette smoking, alcohol use, and drug use, which increase your risk of many conditions and complications.
The first and most important step is to get started with treatment for HIV (if you are not already on treatment) and stick with treatment. Keeping the virus under control with medication is the most important thing you can do for your health.
Medically reviewed in July 2019
