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Why are people with HIV considered “older adults” in their fifties?

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Abstract

One in six new HIV diagnoses in Europe occur among people over 50 years of age. As in the general population, the aging process is not homogeneous among older adults with HIV, and some of them exhibit impaired physical function, higher frailty and more frequent geriatric syndromes. These illness reflect a higher biological age independently of their chronological age. After starting antirretroviral treatment, people living with HIV (PLWH) older than 50 exhibit a poorer immunological recovery than younger PLWH. Moreover, older adults with HIV present early onset of comorbidities and functional impairment caused by persistent and chronic activation of the immune system, which leads to immune exhaustion and accelerated immunosenescence despite optimal suppression of HIV replication. The evidence of poorer immunological response to ARV, linked with early immunosenescence in PLWH and its prematurely deleterious effect in physiological functions and its clinical consequences, are the basis to accept the cut-off of 50 years of age to define an “older adult with HIV”.

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Authors and Affiliations

  1. Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Carretera de Colmenar km 9, 100, Madrid, Spain

    Matilde Sánchez-Conde, Jorge Díaz-Alvarez & Fernando Dronda

  2. Instituto de Investigación del Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain

    Matilde Sánchez-Conde

  3. Hospital Universitario Infanta Leonor, Madrid, Spain

    Fátima Brañas

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  1. Matilde Sánchez-Conde
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  2. Jorge Díaz-Alvarez
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  4. Fátima Brañas
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Correspondence to Matilde Sánchez-Conde.

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Conflict of interest

MSC has received honoraria for the following: speaking at symposia organized on behalf of MSD, ViiV Healthcare and Gilead. FBB has received honoraria for the following: research grants from MSD, speaking at symposia organized on behalf of MSD and ViiV Healthcare; developing educational materials for MSD; and board membership from ViiV Healthcare. JDA has no conflict of interest. FD has no conflict of interest.

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Sánchez-Conde, M., Díaz-Alvarez, J., Dronda, F. et al. Why are people with HIV considered “older adults” in their fifties?. Eur Geriatr Med 10, 183–188 (2019). https://doi.org/10.1007/s41999-018-0148-x

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