An enormous quantity of important and fascinating HIV research is presented each year at the Conference on Retroviruses and Opportunistic Infections (CROI). We have published almost 40 news articles from this year’s conference. As it is hard for anyone to keep up, here is a round-up of the news on ageing and associated health problems in the people living with HIV from the conference.
HIV-positive people who start HIV treatment promptly and have good access to medical care have the same life expectancy as their HIV-negative peers, but they live with additional health problems for many of those years. In an American study, they had major co-morbidities an average of 16 years earlier than HIV-negative people.
Weight gain after starting HIV treatment is likely to raise the risk of diabetes but does not push up the risk of heart disease. The two studies reported are some of the first to shed light on the potential implications of weight gain linked to modern HIV treatment, especially the drugs dolutegravir and tenofovir alafenamide.
There was some good news about treatment for abnormal cell changes that could be a precursor to anal cancer. In a small study, anal lesions caused by human papillomavirus (HPV) were cleared by a drug that is already approved for the treatment of myeloma, a blood cancer.
Fatty liver disease, which occurs when fat builds up in liver cells, appears to be more severe in people with HIV than in the general population. Rates of liver fibrosis (a ‘stiff’ liver) and a worsening of fibrosis were high in a US study.
Turning to heart health, a study found a link between testosterone replacement therapy and atherosclerosis. HIV-positive men using testosterone injections or patches had a greater and faster build-up of plaque in their arteries than men not taking testosterone.
Also, insomnia (difficulty falling or staying asleep) was associated with heart attack in people living with HIV, but this was only relevant for one of the two main types of heart attack.
Finally, in terms of damage to the lungs, people living with HIV under the age of 50 lose lung function faster than HIV-negative people of the same age. Action to stop lung damage – such as stopping smoking – should be taken promptly. In those over the age of 50, results were similar between HIV-positive and HIV-negative people.