Researchers presented several studies last week at the 2010 International AIDS Conference that focused on the relationship between HIV and aging.

Some of the studies found that HIV-related diseases and complications, such as osteoporosis, heart problems, and sexual dysfunction, are more prevalent in older adults with HIV.

However, several studies also showed positive results, including unexpected data showing HIV may not cause faster immune system and brain decline with age. Additional studies showed the benefits of exercise and strength training and the effectiveness of Selzentry (maraviroc) in older patients with HIV.

Postmenopausal HIV-Positive Women Are At Increased Risk of Osteoporosis

A study of 35 postmenopausal women with HIV aged 45 or older revealed a high prevalence of the bone disease osteoporosis.

After measuring bone density in the spine and hip, researchers found that 18 percent of the women had osteoporosis and 59 percent had osteopenia, low bone density that can lead to osteoporosis.

For postmenopausal women over 50, rates of osteoporosis and osteopenia are usually around 7 percent and 40 percent, respectively.

The researchers were uncertain why HIV-positive women have higher rates of osteoporosis and suggested further study.

Higher Risk of Heart Disease and Sexual Dysfunction, but not Depression

A large German study compared the frequency of heart disease, sexual dysfunction, and depression in three groups of people over 50 years old.

The three groups consisted of HIV-positive people, HIV-negative people with diabetes, and a group of patients who had no chronic or progressive diseases.

In one arm of the study, researchers assessed the risk of heart disease in the three populations. They found that the HIV-positive patients were at a greater risk of heart disease than the patients without chronic or progressive diseases, but not as high a risk as participants with diabetes.

Additionally both the HIV-positive patients and HIV-negative patients with diabetes had significantly lower “good” cholesterol (HDL) levels than the patients without chronic or progressive diseases.

The German study also examined sexual difficulties in men in the three groups and found that moderate or severe sexual complaints were more often reported by HIV-positive patients (77 percent) than either the HIV-negative patients with diabetes (74 percent) or the patients without chronic or progressive diseases (63 percent), regardless of whether or not the patient had a stable partner.

However, there was a significant link between decreased sexual function and advanced age in all three of the groups.

In addition, the researchers investigated the rate of depression in the three groups. About a third of HIV-positive participants were classified as having a depressive disorder, which was similar to the other two groups.

The researchers found that socio-economic factors, such as the presence or absence of a stable relationship and employment, were the largest influences on development of depression.

HIV May Not Lead To Faster Brain Aging

An ongoing study at the University of California, San Francisco, is studying the brain function of men and women with HIV who are aged 60 years or older. So far, researchers have found that nearly half of the study participants (47 percent) have some degree of mental impairment: 5 percent of patients have dementia, 23 percent have mild mental impairment, and 19 percent have minor mental impairment that has no effect on daily functioning.

However, the scientists noted that these are similar to the rates found in younger HIV-positive adults, which contradicts the currently held view that HIV leads to faster brain aging.

The researchers believe that there may be a common factor that increases both the risk of mental impairment and early HIV-related mortality – in other words, adults who show HIV-related mental impairment may also be more likely to die at a younger age.

As a result, adults who have survived into old age with HIV would not be more prone to mental impairment than their younger counterparts.

The researchers plan to further investigate the possible connection between HIV-related mental impairment and early HIV mortality.

Age May Not Weaken the Immune System Of HIV-Positive Adults

This study investigated the relationship between HIV-related immune system deterioration and aging in patients with viral suppression. The study compared HIV-infected adults aged 55 years or older to people with HIV between the ages of 25 and 40. All participants had viral loads (amount of virus in the blood) of 50 copies per milliliter or less.

Researchers hypothesized that higher death rates in older HIV-positive adults, even those with viral suppression, might be due to immune system deterioration as people age.

They found that there was no clear relationship observed between age and decreased immune function. They also found that there were almost no significant age-associated immune changes, which surprised the researchers.

The results suggest that higher mortality in older HIV-positive adults may not be due to faster immune system degeneration.

Resistance Training Is Highly Effective In Older Adults With HIV

Another study demonstrated that after a year of resistance training, people with HIV ages 60 and older were able to achieve strength equal to people of the same age without HIV.

Researchers compared the effects of one year of resistance training on muscular strength, physical fitness, and body composition in older adults with and without HIV. Both groups of participants performed exercises for the major muscle groups twice a week.

Although people with HIV started off weaker and with less muscle than participants without HIV, they gained more strength faster. By the end of the study, there was no difference in strength between the two groups.

The results suggest that older adults with HIV can significantly improve their strength and body health to normal levels with regular resistance training.

Small Study Suggests Selzentry Is Safe and Effective In Older HIV-Positive Adults

A small study evaluated the safety and efficacy of Selzentry in six treatment-experienced patients with HIV who were over 60 years old.

Results showed that the medication was highly effective, with participants reaching viral suppression (viral load of less than 50 copies per milliliter) within a median of 1.5 months, with a median CD4 cell count increase of 10 cells per month.

In all cases, Selzentry was combined with other new antiretroviral medications, including Prezista (darunavir), Intelence (etravirine), and Isentress (raltegravir).

Selzentry was generally well-tolerated. However, the patients did exhibit a slight increase in triglycerides, a form of fat in the body that is associated with increased risk of heart disease.

For more information, please see the AIDS 2010 conference website. 

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