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HIV in Older Adults

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Geriatric Gastroenterology

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Abstract

Human immunodeficiency virus (HIV) infection is the cause of acquired immunodeficiency syndrome (AIDS). HIV disease continues to be a significant public health problem, although highly active antiretroviral therapy (HAART) has changed the dismal prognosis that existed in the 1980s. Life expectancy for people living with HIV (PLHIV) in the USA has significantly improved in the HAART era. Globally, 5.8 million (16%) PLHIV were older than age 50 years in 2015; the proportion of older PLHIV will rise to 22% in 2020. The burden of the epidemic differs between countries and regions within countries. Sub-Saharan Africa remains most severely affected. Older age with HIV infection presents unique challenges because both older age and HIV disease increases the risk for cardiovascular disease, bone loss, and certain cancers. Older HIV patients have multimorbidity. Opportunistic infections are currently rarer mostly seen in newly diagnosed patients, but drug-related liver toxicities and age-related comorbid conditions have increased. The gastrointestinal (GI) manifestations are rare since the advent of HAART except in individuals not on treatment either because the diagnosis was missed earlier or the treatment was not offered.

Profound involuntary weight loss or wasting (cachexia, a wasting syndrome) indicative of severe protein-energy malnutrition is a frequent complication of AIDS. In HIV, mucosal tissues are the primary sites of viral transmission and significant sites for viral replication. Hence various opportunistic infections, bacterial, viral, and parasitic of the gastrointestinal tract predominate in the clinical manifestations.

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Authors and Affiliations

  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, New York Medical College, Valhalla, NY, USA

    C. S. Pitchumoni

  3. Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peters University Hospital, New Brunswick, NJ, USA

    C. S. Pitchumoni

  4. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Mitesh A. Desai

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Correspondence to Mitesh A. Desai .

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  1. Department of Medicine, Robert Wood Johnson School of Medicine, Rutgers University, New Brunswick, NJ, USA

    C. S. Pitchumoni

  2. Department of Medicine, Division of Geriatrics, Montefiore Medical Center, Wakefield Campus, Bronx, NY, USA

    T.S. Dharmarajan

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Pitchumoni, C.S., Desai, M.A. (2021). HIV in Older Adults. In: Pitchumoni, C.S., Dharmarajan, T. (eds) Geriatric Gastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-030-30192-7_91

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