title: Management of human immunodeficiency virus infection in advanced age.
abstract: OBJECTIVE
  Human immunodeficiency virus (HIV)-positive patients treated with antiretroviral therapy now have increased life expectancy and develop chronic illnesses that are often seen in older HIV-negative patients.
  
  
  OBJECTIVE
  To address emerging issues related to aging with HIV. Screening older adults for HIV, diagnosis of concomitant diseases, management of multiple comorbid medical illnesses, social isolation, polypharmacy, and factors associated with end-of-life care are reviewed.
  
  
  METHODS
  Published guidelines and consensus statements were reviewed. PubMed and PsycINFO were searched between January 2000 and February 2013. Articles not appearing in the search that were referenced by reviewed articles were also evaluated.
  
  
  RESULTS
  The population of older HIV-positive patients is rapidly expanding. It is estimated that by 2015 one-half of the individuals in the United States with HIV will be older than age 50. Older HIV-infected patients are prone to having similar chronic diseases as their HIV-negative counterparts, as well as illnesses associated with co-infections. Medical treatments associated with these conditions, when added to an antiretroviral regimen, increase risk for polypharmacy. Care of aging HIV-infected patients involves a need to balance a number of concurrent comorbid medical conditions.
  
  
  CONCLUSIONS
  HIV is no longer a fatal disease. Management of multiple comorbid diseases is a common feature associated with longer life expectancy in HIV-positive patients. There is a need to better understand how to optimize the care of these patients.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Meredith
authors.initials: M
authors.lastname: Greene
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
authors.forename: Harry W
authors.initials: HW
authors.lastname: Lampiris
authors.forename: Victor
authors.initials: V
authors.lastname: Valcour
mesh_terms: D000368:Aged; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002908:Chronic Disease / Q000517:prevention & control / Q000628:therapy; D019468:Disease Management; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D005791:Patient Care; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D012934:Social Isolation; D013727:Terminal Care
chemical_list: D019380:Anti-HIV Agents
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