HIV and the risk of age-associated disease

In years and decades past, the greatest health threat to people with human immunodeficiency virus (HIV) was autoimmune deficiency syndrome (AIDS). AIDS occurs after the immune system has been badly damaged by HIV infection, leaving the body unable to fight off opportunistic infections and diseases. In the past, AIDS was the expected outcome after having HIV for 10 years. Once a person developed AIDS, they had a life expectancy averaging less than two years.

Today, the prognosis for people with HIV is much better. With treatment, people with HIV can have near-normal lifespans. However, as they live longer, they face another health challenge—age-associated disease.

Aging-associated disease

Growing older isn’t the only risk factor for developing certain diseases. But it’s often a significant one. Common age-associated diseases include:

• Cardiovascular disease
• Osteoporosis
• Type 2 diabetes
• Kidney disease
• Liver disease
• Degenerative neurologic disorders, such as dementia 

While everyone’s odds of having these diseases increase as they age, people who are managing HIV are at an even higher risk. They are also at increased risk for frailty and certain cancers, including Hodgkin lymphoma, anal cancer, soft tissue cancer, and multiple myeloma. People with HIV may also develop age-related diseases at younger ages.

HIV and inflammation

The standard for treating HIV is antiretroviral therapy (ART). It works by disrupting different mechanisms in HIV’s lifecycle and blocking the virus’s ability to replicate. This reduces the viral load (the amount of HIV in the body) to very low levels, allowing the immune system to recover and function. 

Though these treatments keep the virus under control, HIV remains a constant presence in the body—one that can trigger a constant, low-grade inflammatory response from the immune system.

The earlier appearance of age-associated diseases in people with HIV appears to be linked to this inflammation. 

Other factors

Chronic inflammation caused by HIV may not be the only contributing factor. Other possible factors may include:

• The long-term use of HIV treatments
• Having other health conditions in addition to HIV, such as hepatitis C
• Interaction with other medications for other medical conditions
• The use of alcohol, tobacco, and drugs

What you can do

It’s important to remember that living with HIV may put you at an increased risk for age-related diseases like the ones listed above. But there is much you can do to prevent heart disease, type 2 diabetes, liver disease, and osteoporosis. Diet, exercise, and lifestyle play important roles in the prevention of age-associated diseases. Try to:

• Eat a heart-healthy diet
• Exercise regularly
• Change harmful habits like cigarette smoking, alcohol use, and drug use

The first and most important step is to start treatment for HIV (if you are not already on treatment) and stick with it. Keeping the virus under control with medication is the most important thing you can do for your health.