SAN FRANCISCO: Having survived the first and worst years of the AIDS epidemic, when he was losing three friends to the disease in a day and undergoing every primitive, toxic treatment that then existed, Peter Greene is grateful to be alive.
But a quarter-century after his own diagnosis, the former Mr Gay Colorado, now 56, wrestles with vision impairment, bone density loss and other debilitating health problems he once assumed he wouldn't grow old enough to see. "I survived all the big things, but now there is a new host of things. Liver problems. Kidney disease. it's like you are a 50 year old in an 80 year old body," Greene, a San Francisco travel agent, said. "I'm just afraid that this is not regardless of what my non-HIV positive friends say, the typical aging process."
Even when AIDS still was almost always fatal, researched predicted that people infected with HIV would be more prone to the cancers, neurological disorders and heart conitions that typically afflict the elderly. Thirty years after the first diagnoses, doctors are seeing these and other unanticipated signs of premature or "accelerated" aging in some long-term survivors.
Government-funded scientists are working to tease apart whether the memory loss, arthritis, renal failure and high blood pressure showing up in patients in their 40s and 50s are consequences of HIV, the drugs used to treat it or a cruel combination of both. With people over 50 expected to make up a majority of US residents infected with the virus by 2015, there's some urgency to unraveling the "complex treatment challenges". HIV poses to older Americans, according to the National Institutes of Health.
"In those with long-term HIV infection, the persistent activation of immune cells by the virus likely increases the susceptibility of these individuals to inflammation-induced diseases and diminishes their capability to fight certain diseases," the federal health agency's chiefs of infectious diseases, aging and AIDS research wrote, summing up the current state of knowledge on last September's National HIV/AIDS and Aging Awareness Day.
"Coupled with the aging process, the extended exposure of these adults to both HIV and anti-retroviral drugs appears to increase their own risk of illness and death from cardiovascular, bone, kidney, liver and lung disease, as well as many cancers not associated directly with HIV." In San Francisco, where already more than half of the 9,734 AIDS cases are in people 50 and over, University of California, San Francisco AIDS specialists are collaborating with geriatricians, pharmacists and nutritionists to develop treatment guidelines to help veterans of the disease cope with getting frail a decade or two ahead of schedule.
"Wouldn't it be helpful to be able to say, are you at high risk, low risk or moderate risk for progressing to dependency in the next five to the next 10 years. How are they going to interact?" explained Dr. Malcolm John, who directs UCSF's HIV clinic. "All those questions need to be brought into the HIV field at a younger age." -AP
Printed by The Star, 13 June 2011.