Aging and HIV
By the end 2015 more than half of all people living with the HIV virus in the United States will be older than 50 years. A good number of people will simply live much longer with HIV, and that is a good thing. Many, however, will contract HIV when they are over 50 years old, and their health needs will be different from someone who tested positive at a younger age. What's more, research shows' increasingly that the diseases that usually attack HIV-negative people in their 60 and 70 years, occur in people with HIV in their 40 and 50 years. These concerns have taken the issue of aging with HIV to the center of the stage.
Now one of the biggest unanswered questions is why this is occurring. There is no doubt that many age-related diseases and conditions are appearing at higher rates and at younger ages in people with HIV compared to HIV-negative patients; heart attacks, bone fractures, kidney disease or certain types of cancer, and the rates of such conditions in people with HIV are alarming. What was not clear, however, is how HIV contributes to these conditions, as explained by other factors (such as smoking, HIV / AIDS drugs and co-infection with other viruses) and what to do in relation to them.
Researchers are working hard to answer these questions, but in the meantime, this lesson is designed to explain:
- How does aging work in a general sense?
- What do we know about HIV / AIDS and the aging process?
- What measures can be taken to reduce the risk of aging-related diseases, and
- What are the types of experimental treatments that are on the horizon?
The good news is that most people who are HIV positive can do a lot to slow down the aging process and protect against the onset of age-related diseases. Before you get to that, however, it is important to understand how aging works in the first place.
What is aging, and why do we become sick as we get older?
When we think of someone as "old," we tend to think that the person who has lived a certain number of years: 70, 80, 100 is old.
For the National Institute of Aging, however, the focus is not on how long someone has lived, but on the inevitable decline in physical fitness and health, which occurs when a person reaches a later stage of life. But aging researchers are not geared toward the small changes that come with age, gray hair and wrinkled skin.
Instead, they are concerned about the changes that cause disability and illness. This is where efforts are centralized, in the sense of understanding what is potentially slow or reversing aging.
At the same time, researchers have looked at the main cause of aging but they have realized that a variety of factors including our genes, our environment and infection with viruses and bacteria all contribute to the overlapping aging phenomenon.
Some people have won the genetic lottery. They inherit the genes that allow them to remain healthy and well vitalized in their 80 years and 90 years, while other people who inherited other genes are put at higher risk of developing cancer or cardiovascular disease by the time they reach the 40 years .
Some are able to minimize known environmental and behavioral factors to slow down the aging process. Eat well, do exercises and keep socially and intellectually involved in life. On the other hand, others can eat healthy diet, avoid smoking tobacco, exercise or conduct socially isolated lives. The effects of such environmental and behavioral factors on human health are profound.
Similarly, some people are able to prevent the occurrence of infection with most viruses and bacteria throughout their lifetime, or they have immune system capable of keeping infections under control. Others may have immune systems capable of dealing with harmful infections, such as hepatitis B virus (HBV). Hepatitis C virus (HCV). Human Papillomavirus (HPV). Cytomegalovirus (CMV) -and, yes, O- HIV, all of which can significantly increase the risk of health problems later in life.
These genetic, environmental, and biological factors can overlap and lead us to begin the aging process, called "senility," and senescence puts everything down to the cellular level. Yes, the cells grow old too!
The cells in our body depend on a cut with a DNA scissors, called telomere, to reproduce. When we are young, the cells of our body also tend to be young in that they appear to be and act in the same way with the first generation of cells that begin when we were first in the womb. As we age, however, the cells of our organism are many hundreds or thousands of generations taken from the original cells, and the strands of code at the end of the DNA, the telomeres, get shorter. If telomeres are in good shape, such as when they are young, each new generation of cells performs well. When telomeres are very short, however, each new generation of cellular functions reproduces worse, to the point where cells sometimes fail to reproduce.
What does this have to do with aging? Enough! Defective cells lead to real problems. If our muscles and bone cells fail to make new cells work well because the telomeres have become too short - this makes our muscles and bones more likely to be weak. Weak muscles and bones mean a greater risk of falling and a greater risk that we will break a big bone. Defects in brain cells can lead to poor coordination and memory problems. Defects in immune cells are not able to keep infections and cancers under control.
It is the latter category of senescence, called age-related immunosenescence, which is of particular relevance to people living with HIV. More about having age-related immunosenescence will be explained later, but first it is important to understand some of the ways that HIV can affect the aging process.
And that will be addressed in the next chapter.
Translated by Claudio Souza the originals:
Aging and HIV e What is aging, and why do we become ill as we get older? With the invaluable review Mara Macedo