Aging With HIV Expected to Have More Chronic Conditions

[Jim Allen]

A projection made based on current data. I did not see anything new as such or at least not anything that's not already known but thought I would post it.

In full:
https://www.poz.com/article/aging-hiv-chronic-disease-2030

In short:

Aging With HIV Expected to Have More Chronic Conditions

These are the projections of the ProjEcting Age, multimorbidity, and PoLypharmacy (PEARL) simulation model, presented by Parastu Kasaie, PhD, assistant scientist at the Johns Hopkins Bloomberg School of Public Health, at the Conference on Retroviruses and Opportunistic Infections (CROI).

PEARL used data on people living with HIV ages 15 to 85 who had ever started antiretroviral (ARV) treatment in 2009, gathering them from Centers for Disease Control and Prevention surveillance data and the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD).

From each of these sources, the PEARL researchers gathered information on CD4 count at ARV initiation, year of ARV initiation, age, risk factors for comorbidities, such as weight, smoking and hepatitis C, and the overall size of the population. In addition, they collected data on five gender identities and three racial/ethnic identities—Black, white and Latino—as well as how people acquired HIV.

What they project is that the median age of people living with HIV will rise from 50 to 53 by 2030. The good news is that the model projects a jump in people with access to ARVs by 2030—reaching nearly a million, or 928,000. And those people are projected to live longer.

While high blood pressure and high cholesterol are expected to fall slightly over the next nine years, rates of heart attack and other heart disease are expected to increase substantially. Black and white men who inject drugs, Black women and Latinos are expected to see the highest increase in heart problems; only heterosexual men of all three races are expected to be spared the increase.

That increase in heart disease may be partially explained by diabetes, which is expected to rise, especially for heterosexual women of all races—whether they inject drugs or not—and Latino men who inject drugs.

Chronic kidney disease and anxiety are also expected to see major increases across the board. Anxiety is expected to spike especially hard among Latinas who inject drugs and their heterosexual Latino peers. And chronic kidney disease is projected to increase over current rates, especially among white and Latino women who inject drugs and Black heterosexual women.

When they combined all these conditions, the researchers expect that the proportion of people with two or more non-HIV health conditions will rise from 30% in 2020 to 36% in 2030—an increase of 251,000 people.

This future isn’t fixed, however. Many of these conditions, especially anxiety, diabetes, high blood pressure and high cholesterol, can respond well to exercise, diet changes and mindfulness practices. But people living with HIV can’t do it alone, Kasaie said.