Key points
- HIV treatment works well for older people and viral load drops to an undetectable level quickly.
- HIV treatment also helps protect against heart disease, cancer, kidney and liver disease.
- Depending on other medications you may be taking and health issues, you may need dose adjustments.
Studies show that HIV treatment works well for older people. Viral load drops to an undetectable level (the aim of treatment) just as quickly as it does in younger people. Older people are often better than younger people at taking their medication as prescribed.
On the other hand, people who start treatment over the age of 50 may have a slower and less complete restoration of their immune system. The CD4 cell count doesn’t always rise as quickly as it does in younger adults.
As well as preventing HIV-related illnesses, effective HIV treatment helps protect against heart disease, cancer, kidney and liver disease. Among people living with HIV, rates of these conditions are lower in people who take HIV treatment than in people who do not.
Tailoring your treatment
If you have other health concerns as well as HIV, this can affect the choices you and your doctor make about which HIV drug combination is right for you.
- There could be interactions between one of your anti-HIV drugs and a medicine you take for another health condition. There’s more information on another page.
- As you get older, your body may change. The liver and kidneys may work less efficiently, affecting the way a drug is processed in the body. Because of weight loss, decreased body fluid or increased fatty tissue, medicines may stay in the body longer and cause more side effects. Occasionally, your doctor may need to adjust your dose.
- Some specific anti-HIV drugs are associated with a slightly increased risk of developing some health conditions, or could make a health condition worse for you. If this is the case, you will usually be able to take a different anti-HIV drug.
For these reasons, your choice of anti-HIV drugs may need to be tailored to your specific situation. You may need a different dose of one of your medicines. This may mean that a single tablet, which contains several drugs in fixed quantities, might not always be the right choice for you. You might need to switch from a drug combination that you have got used to.
In the UK, standards for HIV treatment and care are set by the British HIV Association, the professional association for HIV doctors. Their guidelines recommend that doctors exercise caution in prescribing the following anti-HIV drugs to people who have specific health conditions or have risk factors for that condition.
- Depression and other mental health problems: efavirenz.
- Heart disease: abacavir or lopinavir.
- Kidney disease: tenofovir disoproxil or atazanavir.
- Bone problems: tenofovir disoproxil.