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Older HIV-infected adults: complex patients—comorbidity (I)

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Abstract

Life expectancy in people living with HIV has increased in the past decades, since the introduction of highly active antiretroviral treatment. Increased survival comes along with new challenges for the HIV physician, as these patients will present comorbidities inherent to ageing that can appear more frequently and at younger age than the general population. The older HIV patient poses a unique challenge, as management should take into account different factors, some related to global ageing such as geriatric syndromes, traditional risk factors, social vulnerability, and age-related diseases, and others related to HIV infection like ART toxicity, drug–drug interactions, immune dysregulation and chronic inflammation. All the above can amount to great polypharmacy and multimorbidity that physician have to be aware of. Little is known about the best screening, management and treatment strategies to improve long-term health outcomes in this ageing population. The following article briefly reviews the main comorbidities that can affect the ageing HIV patient.

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Acknowledgements

Rosa de Miguel is supported by a Río Hortega fellowship from the Fondo de Investigación Sanitaria.

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  1. HIV Unit, Department of Internal Medicine, Edificio Consultas Externas. Planta Semisótano, Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana 261, 28046, Madrid, Spain

    Rocío Montejano, Rosa de Miguel & José I. Bernardino

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  1. Rocío Montejano
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Correspondence to José I. Bernardino.

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Dr. Bernardino reports grants and personal fees from Gilead Sciences, personal fees from ViiV Healthcare, Janssen Pharmaceuticals, and Merck Sharp & Dohme, outside the submitted work. Dr de Miguel reports personal fees from Gilead Sciences and Janssen Pharma outside the submitted work. Dr Montejano received personal fees from Janssen Pharmaceuticals, personal fees from Merck Sharp & Dohme, and Gilead Sciences outside the submitted work.

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Montejano, R., de Miguel, R. & Bernardino, J.I. Older HIV-infected adults: complex patients—comorbidity (I). Eur Geriatr Med 10, 189–197 (2019). https://doi.org/10.1007/s41999-018-0152-1

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