Frailty among older persons living with HIV: a new burden for their clinical care

Alfonso Zamudio-Rodriguez holds a master’s degree in Public Health and is interested in frailty of older persons living with HIV. He develops his work in the department of Dr. Ávila-Funes @geriatriainnsz at the National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico City.

Population ageing remains a continuous challenge for health care providers due to the escalating number of patients with chronic conditions. This represents a considerable economic burden for health systems across the globe. Ever since its debut in the 80’s, prevention, early diagnosis, and treatment of human immunodeficiency virus (HIV) infection has captured the attention of the scientific community. Highly active antiretroviral therapy (HAART) radically modified the paradigm of living with HIV by prolonging survival and improving the prognosis of a previously terminal disease. Today, thanks to HAART, HIV is a chronic condition with a life expectancy similar to that of the general population and a significantly improved quality of life. However, the changes in survival for HIV infected individuals have unearthed the appearance at an earlier age of health problems that used to be observed exclusively in older adults. Continue reading

Esther Clift’s African Blog Series; Part 3 ‘Palliative care’

Esther Clift is a Consultant Practitioner Trainee in Frailty with Health Education Wessex. This is the third part of a four part BGS blog series about her time in Africa. She tweets @EstherClift

estherThe scourge of AIDS in the 1990s led to the introduction of palliative care as both a medical speciality in symptom management and a community initiative to support people at the end of their lives to live at home with their loved ones. Communities identified and trained community carers to offer practical support for activities of daily needs. Some palliative care facilities were developed, particularly in Uganda where AIDS was rife, and the government and NGOs were particularly proactive in both prevention measures and care, as both centres of training and excellence, as well as hospice care. Continue reading

Significant rise in older people living and being diagnosed with HIV

A new paper published online today in Age and Ageing argues that despite a year-on-year increase in the number of people over the age of 50 being diagnosed with the Human Immunodeficiency Virus (HIV), there is a reluctance of healthcare professionals to offer HIV tests to older people. This results in high rates of “late presentation” and therefore significantly increased mortality.shutterstock_139099559

According to the article by Dr Eva Bunting and colleagues, of the Royal Sussex County Hospital, the proportion of older patients in the UK living with HIV has increased significantly. They quote the most recent Public Health England data, which shows that of an estimated 73,660 people living with HIV, in 2002 12% (3,640) were over 50 years old, while in 2011 that figure rose to 22% (16,550). In Brighton, where Professor Martin Fisher is based, this figure is as high as 35%.

There have been dramatic developments in HIV management since the introduction of combination antiretroviral therapy (cART) in 1996, but as the population of older people living with HIV increases, new challenges continue to emerge. Continue reading

Early diagnosis and treatment of HIV infection in older patients

Daniel Davis is a Research Training Fellow at the Institute of Public Health at Cambridge University and SpR in Geriatric Medicine at Oxford Radcliffe Hospitals.

It has recently become clear that HIV is increasingly affecting the older population. Notifications of new infections to the UK Health Protection Agency are rising in the over 50s, and this subgroup presents different characteristics compared to those typically associated with the HIV epidemic.

Of course, better treatments mean that life expectancy is now much greater in those with chronic infection, and so prevalence of HIV is increasing among those in their fifties and sixties. But this is not the area of concern. Continue reading