HIV and Aging

The HIV Population Is Aging1-4

According to the CDC, in 2018, more than 48% of PLWH were ≥50 years of age

Informational icon stating more than 70% of Americans with HIV will be 50+ years of age in 2030.
  • According to DHHS guidelines, for older PLWH, ART is especially important because they potentially have a blunted immunologic response to ART
  • Additionally, elevated markers of immune activation and inflammation also increase with aging. The rate of this age-related change was demonstrated to be faster in people with HIV with viremia than in those with virologic suppression on ART
  • Although levels of immune activation and inflammation decline with ART, they may remain higher than normal even with suppressive ART
Infographic showing the effect on the immune system after HIV infection and after ART initiation.

The immune system is weakened


The immune system improves vs baseline

For aging PLWH experiencing declining immune systems, long-term virologic suppression is a critical treatment goal

Generally, as PLWH age, they may experience an increased rate of chronic comorbidities—and these may require additional medications.

Chronic comorbidities in PLWH by age categories4,*

Graphs showing an increased rate of chronic comorbidities as PLWH age.

Concurrent comorbidities in this analysis were considered common age-related, non-infectious chronic conditions and included hypertension, diabetes mellitus, hypothyroidism, cardiovascular disease, and bone fractures. Totals do not add up to 100% since the percentage of patients with 0 comorbidities were excluded.

*2002-2009 data collected from ART-experienced HIV-infected adults from an Italian cohort.

  • According to DHHS guidelines, older PLWH have a higher prevalence of polypharmacy than those without HIV
  • In a review of medications commonly prescribed to older patients, more than half of HIV and non-HIV medications had the potential for DDIs

Polypharmacy and convenient dosing should be considered when making treatment decisions for aging PLWH who may have multiple chronic comorbidities

Please see full Prescribing Information for BIKTARVY® and DESCOVY®, including BOXED WARNINGS.

ART, antiretroviral therapy; DDI, drug-drug interaction; DHHS, US Department of Health and Human Services; PLWH, people living with HIV.

References: 1. Wing EJ. The aging population with HIV infection. Trans AM Clin Climatol Assoc. 2017;128:131-144. 2. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. Department of Health and Human Services. Updated May 26, 2023. Accessed June 26, 2023. 3. Nabatanzi R, Cose S, Joloba M, Rowland Jones S, Nakanjako D. Effects of HIV infection and ART on phenotype and function of circulating monocytes, natural killer, and innate lymphoid cells. AIDS Rev Ther. 2018;15(7):1-8. 4. Guaraldi G, Orlando G, Zona S, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53(11):1120-1126.