Aging and neuro-AIDS conditions and the changing spectrum of HIV-1-associated morbidity and mortality.
Older individuals (>50 years of age) now comprise over 11% of patients with AIDS in the United States. This percentage is expected to continue to grow, due both to the improved longevity of patients prescribed highly active antiretroviral therapy (HAART) and to new infections among older individuals. This review focuses on the neuropsychiatric and neurological conditions that are most likely to be affected by advancing age-HIV-1-associated cognitive-motor disorder, peripheral neuropathy, progressive multifocal leukoencephalopathy, primary CNS lymphoma, and risk for cerebrovascular accident. Age associations with incidence of these disorders and with treatment foci are specified. Implications for future changes in management are discussed.
Goodkin
K
K
Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, 1400 NW 10th Ave, #803-A, Miami, FL 33136, USA. KGoodkin@med.miami.edu
Wilkie
F L
FL
Concha
M
M
Hinkin
C H
CH
Symes
S
S
Baldewicz
T T
TT
Asthana
D
D
Fujimura
R K
RK
Lee
D
D
van Zuilen
M H
MH
Khamis
I
I
Shapshak
P
P
Eisdorfer
C
C
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology; D000367:Age Factors; D002493:Central Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D016543:Central Nervous System Neoplasms / Q000453:epidemiology / Q000209:etiology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000209:etiology; D018450:Disease Progression; D015497:HIV-1; D006801:Humans; D015994:Incidence; D007968:Leukoencephalopathy, Progressive Multifocal / Q000453:epidemiology / Q000209:etiology; D016483:Lymphoma, AIDS-Related / Q000453:epidemiology / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000453:epidemiology* / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology