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Another Kind of AIDS Crisis: Aging HIV, New York Magazine Article
 
 
 
 
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Another Kind of AIDS Crisis
A striking number of HIV patients are living longer but getting older faster.
 
A striking number of HIV patients are living longer but getting older faster-showing early signs of dementia and bone weakness usually seen in the elderly.
 
New York Magazine By DAVID FRANCE
NOV 1 2009
 
"Aging is the No. 1 problem in HIV today"...."Issues of aging with HIV, compared to that, is like a subtitle. It has no political thrust to it at all,"....."This needs urgent, comprehensive attention," "patients who contracted the virus just a few years back are showing signs of what's being called premature or accelerated aging. Early senility turns out to be an increasingly common problem"
 
"Doctors are also reporting a constellation of ailments in middle-aged patients that are more typically seen at geriatric practices, in patients 80 and older. They range from bone loss to organ failure to arthritis. Making matters worse, HIV patients are registering higher rates of insulin resistance and cholesterol imbalances, and they suffer elevated rates of melanoma and kidney cancers and seven times the rate of other non-HIV-related cancers."
 
52 percent of all Americans infected with HIV (the mean age of which is just 43) suffer from some type of cognitive impairment....Among people without HIV, around 10 percent of individuals under 60 experience such problems.
 
In a dramatic move last week, the National Institute of Allergy and Infectious Diseases upped the ante even further by announcing a massive new plan to test virtually every single adult in the Bronx and the District of Columbia-homes to some of the highest rates of infection in the country-and put everybody who tests positive on anti-HIV drugs, whether they have depleted T-cell counts or not.
 
There's a whole bunch of information we need before pushing forward with this."....the proposal is fraught with ethical peril.....a number of leading researchers have called for more research on the drugs' side-effects before putting more people on them, according to Jeffrey Laurence, a professor of medicine at Weill Cornell Medical College in New York
 
It is true that the clinical picture of life with treated HIV disease is only now beginning to come into focus. A study presented at a conference in February in Montreal showed that otherwise healthy people on HIV medications at about 56 years of age had immune systems comparable to HIV-negative subjects whose median age is 88
 
One study found that 55-year-olds who are HIV-positive have all the telltale signs of late-life frailty-muscle loss, fatigue, and rheumatological disorders

 
Brain impairments are the unexpected new minefield among HIV-positive people who have been on protease inhibitors. According to research presented this summer at the international AIDS conference in Cape Town, South Africa, 52 percent of all Americans infected with HIV (the mean age of which is just 43) suffer from some type of cognitive impairment-mostly mild or moderate dementias, but which nonetheless can impede one's ability to function on a day-to-day basis. This is a staggering finding. Among people without HIV, around 10 percent of individuals under 60 experience such problems.
 
It is surprising that this is generating so little attention. Among activists, Jules Levin, from the National AIDS Treatment Advocacy Project, has been alone in calling for more resources to study aging and AIDS, while others have turned their attention-and money-to fighting the plague in Africa and elsewhere. "Issues of aging with HIV, compared to that, is like a subtitle. It has no political thrust to it at all," Levin says. "I'm not saying we should ignore the rest of the world, but domestic AIDS has been totally neglected, because we're sending all the money overseas."
 
In the meantime, the frontline doctors I spoke to are crying out for help. "This needs urgent, comprehensive attention," says Paul Bellman, a prominent HIV doctor in the Village who has noticed a significant increase in such patients in the past six months. One called recently to say he risked losing his demanding job because of a sudden inability to recall simple tasks. "I wish I could say, 'I'm so glad you called me, because this is what's causing it.' But I don't have the answers. Nobody does."
 
 
 
 
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