Current HIV/AIDS Reports

, Volume 7, Issue 2, pp 69–76 | Cite as

HIV and Aging: Time for a New Paradigm



The population of patients with HIV infection achieving viral suppression on combination antiretroviral therapy is growing, aging, and experiencing a widening spectrum of non-AIDS diseases. Concurrently, AIDS-defining conditions are becoming less common and are variably associated with outcome. Nonetheless, the spectrum of disease experienced by those aging with HIV remains strongly influenced by HIV, its treatment, and the behaviors, conditions, and demographics associated with HIV infection. Our focus must shift from a narrow interest in CD4 counts, HIV-RNA, and AIDS-defining illnesses to determining the optimal management of HIV infection as a complex chronic disease in which the causes of morbidity and mortality are multiple and overlapping. We need a new paradigm of care with which to maximize functional status, minimize frailty, and prolong life expectancy. A composite index that summarizes a patient’s risk of morbidity and mortality could facilitate this work and help chart its progress.


HIV Aging Cormobidity Alcohol use Smoking Drug use Immune senescence Microbial translocation Treatment toxicity 



No potential conflict of interest relevant to this article was reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Yale University Schools of Medicine and Public HealthNew HavenUSA
  2. 2.VA Connecticut Heathcare SystemWest HavenUSA

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