Effective therapies have transformed HIV infection into a chronic disease, and new problems are arising related to aging. This article reviews the aging process, age-related deficit accumulation and frailty, and how these might be affected by chronic HIV infection.
Aging is characterized by acceleration in the rate of unrepaired physiologic damage an organism accumulates. HIV infection is associated with many factors that might affect the aging process, including extrinsic behavioral risk factors and co-infections, and multiple intrinsic factors, including intercellular communication, inflammation, and coagulation pathways. Whether each factor affects the aging process, they likely result in an increase in the risk of adverse health outcomes, and so give rise to frailty, likely with several clinical manifestations.
Age-related deficit accumulation is influenced by both the background or environmental rate of insults an organism sustains and the efficacy of intrinsic damage control and repair mechanisms. Both processes are likely affected in people living with HIV infection.
aGeriatric Medicine Research
bFaculty of Medicine, Dalhousie University
cCentre for Healthcare of the Elderly, QEII Health Sciences Centre, Capital District Health Authority, Halifax, Nova Scotia, Canada
Correspondence to Kenneth Rockwood, Geriatric Medicine Research, Dalhousie University, 1421-5955 Veterans’ Memorial Lane, Halifax, NS, Canada B3H 2E1. Tel: +1 902 473 8631; fax: +1 902 473 4908; e-mail: kenneth.rockwood@Dal.ca