Rapid Aging

As people with HIV live longer, they experience aging processes. Are they aging differently than people without HIV? What are the similarities to typical aging and what is different about aging with HIV? There are no clear answers to these issues. Research continues to probe and understand the interaction of HIV with aging. Still, the older adult may wonder if they are experiencing aging not only differently but earlier than others. Some may attribute every ache, pain, lost memory, and any illness to HIV. Perception is reality. Are those conditions (comorbidities) typically seen as part of the aging process occurring at accelerated rates or with higher frequency (accentuated) in people with HIV?

At this juncture, the science is not conclusive. Some researchers conclude that accelerated aging is occurring due to HIV. The term “accelerated aging” refers to the theory that HIV may speed up the natural process of aging and result in the earlier onset of diseases and conditions such as heart disease, kidney failure, cancer, etc. Anecdotal evidence and some research reports indicate that HIV might lead to earlier onset of diseases of aging. However, this interpretation is not consistent with the findings of other research studies.

The challenge for understanding the issue of rapid aging is designing studies with large samples consisting of people with and without HIV and to track the two groups over time. Research needs to include comparisons between groups not just of similar age and gender, but to also account for other factors such as socioeconomic class, education, insurance, life experience, alcohol and recreational drugs, and other risk factors that can affect health status and outcomes.

A landmark study of U.S. veterans has provided the best evidence of the effect of HIV on diseases associated with aging. The study found that heart disease, kidney failure, cancer, and other diseases occur at about the same time in the people with HIV but with more frequency than in people without HIV. The conclusion is that HIV does not cause an “acceleration”, but rather “accentuation” of those conditions associated with aging. Other studies are needed to confirm these results, but it appears the diseases are not occurring prematurely but rather in greater numbers.

What you can do with your doctor

If you are not yet taking HIV medications for any reason, you should start therapy immediately to reduce the negative effects of the virus. The availability of single pill regimens makes adherence to the HIV medications easier.
Finally, you should follow your medical regimens faithfully and have any needed lab tests or other procedures.

What you can do yourself

A positive attitude can help you cope with the challenges of aging. Your beliefs, whether they are right or wrong, can significantly affect your behaviors and emotions. For example, if you have a fatalistic attitude about aging, you may engage in unhealthy behaviors. You also might feel more anxiety beyond typical concerns of aging that can negatively affect your health.

In 2010, two HIV researchers observed that accelerated aging in the older adult with HIV is an “intriguing” hypothesis, but we should not accept it without more evidence. Accelerated aging may be a common perception, but it remains to be proven.

Whether the problem is accelerated or accentuated aging, right now the best approach is to do what you can to address the challenges presented by the risks for developing multimorbidity and keep a positive attitude about the future. Statistics on longevity are on your side.