HIV disease and advanced age: an increasing therapeutic challenge.

摘要: The mean age of patients at both first HIV detection and AIDS diagnosis is progressively rising over time. However, reliable epidemiological estimates, clinical data or controlled therapeutic outcome figures are lacking for elderly patients, especially with regard to laboratory response antiretroviral therapy, treatment tolerability, drug-drug interactions, short- long-term toxicity, interactions underlying illnesses concurrent pharmacological treatment. In fact, the large majority randomised, trials evaluating comparing new drugs anti-HIV strategies, as well antimicrobial chemoprophylaxis HIV-related complications, either excluded advanced and/or disorders did not offer substudies detailed analysis focusing on older compared younger ones. life expectancy HIV-infected persons receiving highly active therapy (HAART) now extended (approaching that general population), so definition has lost its significance thanks immune reconstitution resulting from potent therapy. an ever-increasing number individuals aged ≥50 years infection expected in coming years, a result increased survival treated disease delayed recognition occult disease. limited available about combined seem show overlapping virological success rate but slower blunted recovery patients. Thymic output, however, seems somewhat preserved even adulthood may contribute most quantitative functional T cell abnormalities caused by More attention must be paid end-organ disorders, drug toxicity interfere HAART efficacy patients’ compliance recommended regimens could lead adverse effects. guidelines prophylaxis AIDS-related should regularly updated include problems related aging population. Specific people warranted obtain all issues elderly, including time mode initiation, modification salvage regimens. Antiretroviral dosage adjustment take into account pathological conditions other treatments another emerging issue.