[Treating HIV disease: back to the patient?]

Area of Science:

• Infectious Diseases
• Gerontology
• Public Health

Background:

• Human immunodeficiency virus (HIV) disease has transitioned from a fatal illness to a chronic condition due to effective antiretroviral therapy.
• This therapeutic advancement has led to decreased opportunistic infections but an increased prevalence of age-related noncommunicable comorbidities in people living with HIV.
• The aging HIV population is projected to experience a significant rise in comorbidities and frailty.

Purpose of the Study:

• To highlight the evolving landscape of HIV disease management.
• To emphasize the growing burden of comorbidities and frailty in aging individuals with HIV.
• To inform therapeutic strategies that consider long-term patient outcomes and well-being.

Main Methods:

• Review of current literature on HIV disease progression and management.
• Analysis of trends in opportunistic illnesses and noncommunicable comorbidities in HIV-infected populations.
• Examination of the impact of aging and chronic inflammation on health outcomes in people with HIV.

Main Results:

• HIV is now a manageable chronic condition, with reduced incidence of opportunistic illnesses.
• Increased prevalence of cardiovascular, metabolic, renal, bone, and hepatic diseases in people living with HIV.
• Projected high rates of comorbidities and frailty in older adults with HIV by 2030.

Conclusions:

• Current HIV treatment strategies must evolve to address the rising tide of comorbidities and frailty.
• Therapeutic choices should balance viral suppression with long-term adherence, reduced toxicity, immune restoration, and prevention of chronic inflammation.
• Patient-reported outcomes and overall well-being are crucial metrics for evaluating the success of HIV management.