HIV-infected people are living for years, but age-related diseases set in early

https://www.washingtonpost.com/nati...2a366b72f2d_story.html?utm_term=.bfe3e5279ad8

Excerpts:

“Most people assume that the medicines have worked and that everything has gone back to normal, and that’s not really true,” says Hardy, who directs research for Whitman-Walker Health in Washington and who still sees patients weekly. “While we have suppressed HIV very well, we’ve now discovered that the medicines only treat part of the problem.”

Many HIV-infected people, now in their 50s and 60s, who have lived for years with HIV under control, are developing aging-related conditions — heart, liver and kidney disease, certain cancers and frailty, for example — at a rate significantly higher than uninfected people of the same age. “These are things that people develop all the time as they get old, but they are occurring at an earlier age in HIV-positive people,” Hardy says.


"HIV not only damages the immune system, it also turns on that system indefinitely, meaning the immune response triggered by HIV never really shuts down, even once drugs have begun to quell the virus. “With most infectious invaders, the immune system responds and then is supposed to rest, like a fire engine waiting to come out when there is a fire to be fought,” Dieffenbach says. “With HIV, those firetrucks keep driving around looking for fires, even when there are none.”


Leaky gut
“Very shortly after someone is infected, the lymphatic system in the gastrointestinal tract undergoes a major transformation” known as microbial translocation, often called “leaky gut,” a condition where microbes from the GI tract escape and enter the bloodstream, according to Amy Justice, a professor of medicine at Yale University who studies HIV among veterans. “It happens quickly after infection, and we’re not very good at preventing it. Even when we treat them [with anti-HIV drugs] early, they still have more microbial translocation than people who don’t have HIV — and it feeds the chronic inflammation.”

 

Wow, that's interesting. I guess from a selfish POV it might be that we benefit from knock ons in hiv research. Are they reporting any CFS like symptoms as a consequence?

 

I wonder if the drug cocktail also contributes to their early demise.

 

According to comments I've heard from Prof Sharon Lewin, a well known HIV researcher and the Director of a very large infectious diseases & immunology research institute (the Doherty Institute), the prognosis for HIV patients depends on their treatment history.

Patients who start treatment early and have only ever been on the current generation of HIV drugs are understood to have normal life-expectancy and general health risks (ie prognosis is no different to a non-HIV person of the same age, gender, BMI etc).

However, if an HIV patient:
(1) Didn't start treatment early (and many procrastinate);
or
(2) Don't take their pills daily (and many don't);
or
(3) Started treatment before the current generation of drugs were available;
Then he/she will be at significant risk of early onset of the ageing-related illnesses mentioned in this article.