Today, more than half of all people living with HIV in the United States are 50 years of age or older. This is mainly because people are living much longer with HIV thanks to effective antiretroviral therapy (ART), and that these are good news!
The bad news is that research increasingly demonstrates that diseases that usually target people with negative serology in the 60 and 70 years are occurring in people with HIV in their 40s and 50s. These concerns have brought the issue of aging with HIV to the central stage. One of the biggest unanswered questions is why this is occurring. Whether it is heart attacks, bone fractures, kidney disease or certain cancers, the rates of these conditions in HIV-positive people are alarming. It is unclear how much HIV contributes to these conditions and how much is explained by other factors (such as smoking, antiretroviral drugs and infection by other viruses).
But most people with HIV can do much to slow down the aging process and protect against the onset of diseases related to age. Rather, it is important to understand how aging.
What is aging?
When we think of someone as "old," we tend to think that the person has lived a number of years: 70, 80, 100. For the National Institute on Aging, however, the focus is not on how long someone was alive, but on the inevitable decline in physical fitness and health that occurs when a person comes later to life.
There was a time when the researchers looked at a central causes of aging, but they have realized that there are a variety of factors - including our genes, our environment and virus infections and harmful bacteria that contribute to the aging phenomenon overlapping shapes.
Some people just come in the "genetic lottery". They inherit genes that allow them to remain healthy and vital well into their 80 and 90 years, while others have genes that put them at higher risk of developing cancer or cardiovascular disease when they reach their 40 years.
Some people are able to minimize the environmental and behavioral factors known to hasten the aging process. They eat well, exercise practice and remain socially and intellectually engaged in life. The effects of these environmental and behavioral factors on a person's health are profound.
Similarly, some people are able to avoid infection with the virus and most harmful bacteria throughout their lives, or have immune systems capable of keeping infections "under control." Others may have to deal with harmful infections such as hepatitis (HBV), hepatitis (HCV),Virus Human Papilloma Virus (HPV), cytomegalovirus (CMV) and HIV from all that can significantly increase the risk of health problems later in life.
These genetic, environmental and biological factors may overlap and lead us to start the aging process, called "senescence", and senescence will put all the way down to the cellular level.
The cells in our bodies depend on a short DNA scissors called telomeres, to play. When we are young, the cells in our body also tend to be young, they look and act the same way as the first generation of cells that start when we were developing in the womb. As we age, however, the cells of our body are many hundreds or thousands of generations removed from the original cell, and code sections at the end of the DNA telomeres are smaller. If the telomeres are in good shape as when they are young, each new generation of cells works well. When telomeres get too short, however, each new generation of cell functions reproduces worse to the point where sometimes cells can not reproduce all.
Defective cells can lead to real problems. If our muscle and bone cells can not make new cells, which work well because the telomeres become too short, this makes it more likely that our muscles and bones are weak. Muscles and weak bones imply a greater risk of falls and a greater risk that we will break a big bone. Brain cells defective or partially ineffective, can lead to problems of coordination and motor and memory problems. The defective immune cells are unable to maintain the infections and cancers under the control of the continued for perhaps decades, and these attackers may begin to "win areas".
It is this last category of senescence, call immunosenescence related to age, which has particular relevance to people with HIV.
How does HIV affect the aging process?
Educators often explain what happens in the bodies of people with HIV as a battle: a war between the virus and immune cells. HIV is not unique in this respect, however. The immune system is constantly "at war" with a host of organisms harmful viruses and bacteria that have been obtained in our bodies and with our own cells that become defective and start playing very quickly - what we call cancer.
Where HIV differs from many other diseases is that in 99% of people living with HIV, the immune system does not control the virus very well. This constant state of battle, where the virus reproduces and the body fights against it, maintaining the immune system chronically high alert, a call inflammation syndrome.
Inflammation is not inherently bad - we need it to fight infections such as influenza, to repair the damage to body tissues and prevent the growth of certain cancers unchecked inflammation could cause absolute chaos on the body: causing the heart attack buildup and stroke, causing plaque in our arteries, feeding the growth of some types of cancer and the burning of our immune systems.
We have known since the early years of the epidemic that the immune people with HIV system were chronically inflamed, but before the introduction of combination antiretroviral therapy (ART) at the end of 90 decade, most people with HIV died too young and very quickly to the long-term consequences of inflammation are known. Since HAART became available and people began to live longer, scientists were finally able to study the long-term effects of inflammation in people living with HIV.
In the last decade, numerous studies have produced some important findings. We know that inflammation is significantly reduced in people who are able to get and keep their viral loads undetectable using ART. This is one reason that the Department of Health and Human Services (DHHS) recommend treatment guidelines that people start HIV treatment early. Unfortunately, we have also learned that undetectable viral load does not mean that inflammation is completely blocked -he can still be detected and potentially cause problems in people who are responding well to HAART.
While researchers are concerned about how inflammation directly affects the major organs like the heart, liver and kidneys, they are also interested in knowing how chronic inflammation affects the immune system itself. The person's immune system continues the battle against HIV even if ART is being used - most likely to have the experience of having age-related immunosenescence, sometimes also called "immune exhaustion." This condition means that immune cells do not react properly when confronted with a new challenge. They also do not reproduce easily or efficiently. In fact, when scientists have the immune cells of people with HIV, they find that these cells often have the same degree of immune depletion as HIV-negative people who are many decades older.
Are people with HIV suffering from aging faster?
As mentioned above, any number of factors can make people more likely to have age-related diseases and conditions at higher rates and younger ages. People with HIV are more likely to have some of these risk factors than HIV negative people, thus leading to have a health condition worse when they get older. Researchers have also asked how or if the HIV per se is a risk factor for age-related diseases and conditions.
There is no doubt that many of the diseases associated with aging occur at much higher rates in people with HIV and much younger than people not living with the virus. Here are just some of these conditions:
- Bones weakened
- Loss muscle mass and maldistribution of body fat
- Diseases cardio vascular
- Diseases liver
- Diseases kidney
Translator's note: all shown links above lead to another site, in English and I keep them because they have the sink intention to come back here when you have the time to translate them and update the link. Thank you.
Some experts believe a number of factors other than HIV can significantly contribute to these problems. Consider the following:
- People with HIV ARVs, some of which may contribute to bone loss, kidney damage, redistribution of fat and cholesterol and high triglycerides.
- People with HIV are much more likely than the general population to be infected with hep B or hep C; or sometimes all three, and these increase the risk of liver cancer, liver failure, renal disease and diabetes.
- People with HIV are often more likely to be chronically infected with human papillomavirus (HPV), which causes the cervical and anal cancer as well as cancers of the head, neck and throat become immanent threats.
- People with HIV are three times as likely to tobacco smoke, which is a leading cause of heart attacks, stroke and lung cancer and emphysema.
- People with HIV have mental illness and substance abuse rates that are often higher than in people who have HIV and these diseases increase the risk of many other diseases.
Translator's note. I confess I like sensory experiences and sometimes make inappropriate use of some psychotropic drugs. And do not judge me if u spend six months taking a morphine 5ml injection to placate an implacable pain coming from a peripheral neuropathy, and after that, go to take a medication 37 more powerful veze that own morphine you conclude I 5 tablets diazepam and sugar water only has differently, the sweet.
- HIV can infect switch fabric directly on the bone, the brain and the circulatory system and inflammation can damage related to heart, nervous system, liver and kidneys.
These factors likely play important roles in the increase in disease rates related to the aging population and conditions seen in people with HIV. What experts have not yet discovered is how the HIV infection itself may exacerbate the underlying risk factors through inflammation and has immunosenescence age-related-known to contribute to aging-related problems.
Researchers are working to try to understand how quickly the inflammation and has age-related immunosenescence occur in people with HIV, after becoming infected. There is evidence that it begins to happen very soon after a person has contracted HIV, but good control of the virus (either because a person naturally control HIV better or because he or she receives ART) may slow a bit this process .
Experts have not yet agreed on the best way to measure inflammation and measure immunosenescence related to age, and we still do not know how much they contribute independently to diseases related to aging in HIV-negative people or people with HIV. Work is ongoing research, however, to try to answer these questions. However, there is much that the average person living with HIV can do to reduce the risk of many diseases related to age and condition.
You can slow the aging process?
We are far from discovering the fountain of youth, but a number of factors are consistently associated with reduced risk of developing diseases related to age and conditions
Do not smoke tobacco. Smoking tobacco is one of the most harmful things that people can do to their bodies and their chances of living a long and healthy life. Most people know that it can cause lung cancer and other lung diseases. Some even know they can increase the risk of heart attacks and strokes. But it is also associated with numerous other age-related diseases - including bone mineral loss, muscle mass, memory and concentration problems and the age of related cancers such as anal, breast, cervical, and cancer of prostate. Click here For some tips on smoking.
Minimize consumption of alcohol and drugs. Consistent data suggest that moderate alcohol consumption can actually protect the heart and lower blood pressure. However, the American Heart Association recommends that men who drink alcohol should not consume more than two drinks a day and that women should not consume more than one. Studies have found that people who regularly drink more, are at higher risk for stroke, diabetes, obesity and serious accidents. People with HIV who have liver problems have to be especially careful with alcohol.
The data are less clear on how various recreational drugs affect the aging process, although chronic use of amphetamine ("crystal") and cocaine use have been implicated in assessing possible causes of memory problems, bone mineral loss and disease cardiac. In addition, overuse of most drugs is associated with lower life expectancy and increased risk of depression and suicide and other serious (more serious than suicidal? Consequences) to health.
Exercise. On average, people who exercise regularly are much healthier in many respects than people who do not exercise regularly. Physical exercises are good for every specific part of the body.
Here speaks the translator. I remember hearing Dr. Varella Dráuzio somewhere on youtube that the human body is full of "hinges and levers," showing clearly that the human body was made to move and not to the sedentary lifestyle (I I say abusive idleness).
Benefits of regular exercise include reductions in the risk of:
- Cardiovascular diseases, diabetes and metabolic syndrome
- The cognitive decline associated with age
- bone mineral loss and muscle wasting (causing even gain)
Physical exercise (henceforth I make a tacit agreement with the reader and say only exercise) also reduces inflammation throughout the body, with improvement of the symptoms of depression and anxiety, and accelerates recovery when the disease strikes. Not all are equally able to exercise and a doctor must sign on any exercise plan, but there are a number of ways to move around. Click here For some suggestions.
Eat well. In addition to exercise, diet food also helps determine who will live a long and healthy life. Experts are divided on the ideal diet. Some argue against the consumption of just about any fat. Others say that fats, at least healthy fats from for example olive oil, "fruits" like almonds, Brazil nuts and others from this same lineage, avocados and fish are actually very good and are not the problem but, however, sugars in general are detrimental factors to your health. Some argue for a vegetarian way of life, while others claim steaks are just excellent. Diets of "fashion" ("detox" juices, just to name a current one today) come and go just to confuse things even more. All this can make it very difficult to decide on the best diet.
What most reputable diets have in common is to see caloric intake along with an emphasis on including lots of fruit and vegetables whole grains and beans, and then enjoy everything in moderation. Most also stress the importance of eating healthier fish types and limiting the consumption of red meat and consuming more efficient meats such as chicken and fish, especially salmon, where possible by avoiding the skin of these creatures. When it comes to "fat", there is a growing consensus that "healthy" fats - for example, olive oil, "fruits" like almonds, Brazil nuts, and others of this same lineage, and avocados are really good for you .
What most reputable diets also agree on is that too much sugar and too many processed foods (for your sake, avoid those "semi-ready" ones that need only be placed in the microwave for 13 or 14 minutes ... That is organic junk and does not add anything healthy to you, cook your food) and fried foods are the main driver of diabetes, cardiovascular disease and a number of health problems in the United States (in Brazil too). Switching from a "tasty but unhealthy" diet to a healthy way of eating is difficult for many people - that is why so often diets fail. For more information on nutrition and HIV, click here.
Treatment of HIV. Current HIV counseling guidelines recommend starting ARV therapy at least as soon as your CD4 count falls below 500 (editor's note: This text has a certain lifetime where you actually started ART at these levels. START has proven that the best thing to do is start treatment right after diagnosis and take you seriously with draconian behavior when talking about times for outlets. I have not been alive for 22 years with HIV because I stop taking my drugs on end of WEEK) ... The main justification for this recommendation came from data showing that HIV and the consequent elevation of the level of inflammation can substantially increase the risk of cardiovascular disease, liver disease and other conditions. Some experts now recommend further treatment at lower CD4 counts for the same reason especially in those with high underlying risk for cardiovascular disease, liver disease or other health problems.
Not everyone has the same underlying risks for the kinds of diseases that the panel has shown they were worried about, though. For example, people with a family history of heart disease who have never smoked and who do not have the hepatitis C or B virus have a low risk of getting sick with cardiovascular disease, liver or kidney disease. For that person, the decision on when to start treatment may be different than that of a person who does not have a family history of heart disease or who smokes or has HCV. On what account, the guidelines offer some flexibility.
What is clear, however, is that there are more people waiting for the start of therapy after his CD4s count falls below 500, and surely the greater the risk of developing age-related diseases will likely grow. In fact, one of the most powerful predictors of increased risk for most diseases related to age is a CD4 count below 200.
Treat other infections. Current HBV and HIV guidelines recommend that people with both infections should start HIV therapy (with a backbone of treatments that also fight against HBV) as soon as possible. This is because early HBV treatment significantly reduces the risk of liver cancer and other liver problems without significantly increasing the risk of side effects from medications.
There are a number of highly effective treatments currently approved by the Food and Drug Administration (FDA) for the treatment of hepatitis C. Many others are being studied in clinical trials or are awaiting FDA approval. Follow the guidelines for screening for disease prevention and researchers have begun to wonder if certain guidelines for age-related screening may need to start at a younger age in people with HIV. For example, some have questioned whether the most popular screening tools for assessing the risk of heart attack, based on data from the Framingham and long-term study, should be modified for people with HIV.
Experts also close question whether other tools such as the score of "TRAFIC REFRIGERATOR STRENGTHENED FRAX " to assess bone mineral loss may need to be adjusted for HIV positive people. In fact, some now recommend that HIV infection and that low levels alone are sufficient as a risk factor to the bone health screening should start at a younger age, especially in men infected with HIV it is usually recommended.
Studies are being done to help identify the guidelines for the screening of current disease for people over 50 are sufficient for people with HIV. While we await the results of these studies, however, it is important to ask your doctor what kind of disease prevention and guidelines for screening are in place for a person of your age and medical history could be considered and insist on questioning on these guidelines in their own care. For the purpose of resolving their main questions, call the dial AIDS in 0800 16 25 50 and mention that the meeting telenone this site: Soropositivo.Org
Permanently stay socially and mentally connected. Numerous studies have proven that people who maintain social connections with their family, friends and colleagues and engage in activities that they feel add a sense to their life not only live longer but also remain healthier than the people they are socially isolated and not engaging in meaningful activities. There are a variety of ways to be socially connected if you are not close to family and do not have many friends, Facebook, for example, as well as Twitter and Google Plus, as well as Whats App help us stay connected and , who knows, does not roll a more intimate thing, like a dinner by candlelight. Many and local organizations and people care centers living with HIV or AIDS (made up of groups) have support for people with HIV to connect with each other.
Volunteering with the charity that runs the causes you believe in, or a political campaign (ARGH), can also help you connect socially. Diagnosis local groups of people to pursue two objectives: social connection and fitness.
If you can not get out of your house easily, or if you live in a rural area without many opportunities to meet people, you can connect with others online in forums. Check the POZ Forums for topics of your interest and start connecting with other people even today !!!
There is experimental treatments for slowing down the aging process in people with HIV?
Many research teams are looking for ways to slow the aging process, both in HIV positive patients and HIV-negative individuals. So far there is no proven methods to actually reverse aging. Here is a sample of some of the most promising examples of research to slow aging, and some examples of those who are more risky and require care.
Decrease inflammation. As already explained, Chronic inflammation that activates the immune system is constantly harmful in many ways. Not only can it directly damage our blood vessels and vital organs, but it can also accelerate the turnover of our immune cells, leading to possess immunosenescence age-related.
From Wikipedia, the free encyclopedia.
A variety of compounds from some currently available for other conditions and other experimental purposes are being tried in people with HIV to calm the immune system. Drugs available under study include aspirin, HMG-CoA reductase inhibitors (commonly called "statins" and used to lower cholesterol), the input inhibitor Selzentry (maraviroc) and drugs that are commonly used to treat malaria. Experimental drugs include those that have been designed for the treatment of rheumatoid arthritis and other inflammatory diseases.
Stretching and repair of telomeres. If they are damaged or shortened the telomeres lead to immune exhaustion, so we must fight to repair or lengthen them, right? The best answer to that question is yes, but only if we can do it safely. There is a good reason we have evolved in such a way that our telomeres break down if a cell reproduces too much: cells that fail to stop replicate turn malignant. Drugs that stimulate the enzyme telomerase, which helps to maintain telomeres, could hypothetically increase the risk of certain types of cancer. There are some promising drugs early in animal studies, but much research will be needed before they are ready for humans.
More risky alternatives. One of the most written about methods to lengthen animal life and (hopefully) people is extreme calorie restriction. Studies have progressed from insects to small mammals and so far it seems that a diet containing about half the "ideal" calorie amount for an individual animal can significantly increase the lifespan of the animal and increase its health and vitality during those additional years of life. We are a long way from being able to study this method in humans, however, most researchers and health care providers would not recommend that people with HIV start a super-low calorie intake diet.
Another common treatment in "longevity" clinics around the United States is the use of hormones like testosterone, human growth hormone and anabolic steroids. Although each of which has been approved to treat fat and muscle loss common in people with advanced HIV disease (wasting), none are approved to slow or reverse the aging process and all come with side effects that may actually bring other complications increase some age-related conditions such as cardiovascular disease, problems and diabetes. And I, the dite editor, would not use these "things".
Combination antiretroviral therapy is not perfect and all available treatments can cause some side effects; drugs must now be taken regularly definitely for the rest of life; and everyone can stop working. That said, many experts agree that a person who starts antiretroviral therapy early gives a very long shot, and this can cause a person until recently to have a poor prognosis can become a person with a great opportunity to live a normal life almost perfect, with a life expectancy of seventy years or even live up to 80 years! For me, that received a prognosis of six such life ... (...) ...
Although rates of diseases related to age are much higher in people with HIV, it does not mean that all who are HIV positive have multiple diseases by the time to reach their 50s. In fact, actual rates of some diseases related to age remain well under 10% in people with HIV. What is not clear is to be at increased risk of diseases, as we need to be vigilant screening of several diseases and the treatment of any disease will be different in people with HIV.
Researchers are actively working on these issues. However, the best methods available for age-related prevention in physical and mental degradation of the old standbys: diet, exercise, maintaining social connections and abstention from harmful behaviors.
I would like to make a brief manifesto. There have been people who come here, copy all the text, including the pictures and post them on their blogs as if it were their content.
Two people I told and she made the correction; but this thing from getting warning tires and I already notice here. This post, for example, fit in a 17 page word document and I translate into a full night's work. After that came the review and illustration.
I well know that it is not one hundred percent work and this is one more reason.
If I find this post on another blog I will go directly to WordPress complain. Did you like the post? Like the! Do you think it important, reblogue it so that only the introduction of the text to appear on your blog. This work is my and my wife. We deserve a visit!
Cláudio Santos de Souza