Important note: Information in this article was accurate in November 2000. The state of the art may have changed since the publication date.
In the time before protease inhibitors became available, researchers found that, in general, older HIV+ people were more likely to develop AIDS and die faster than younger HIV+ people. In part this is probably related to the fact that as people age, the part of the immune system that fights certain viruses and tumours, called cellular immunity, grows weak.
Doctors in Italy have been studying the impact of highly active antiretroviral therapy, or HAART, on older people, who they defined as those aged 55 years or more, and comparing it to younger people, who they defined as those aged 35 years or less. Researchers used data from 21 older people (8 women, 13 men) whose average lab values were as follows:
They compared the effect of HAART on 84 younger people (29 women, 55 men) whose average lab values were as follows:
All subjects received protease inhibitors (indinavir [Crixivan], nelfinavir [Viracept] or ritonavir [Norvir]) and nucleoside analogues (AZT, ddI and similar drugs) and were monitored for up to 12 months.
The researchers found that HAART reduced viral load equally well in both groups of subjects. When it came to boosting CD4+ cell counts, however, the effect of HAART was less dramatic in older people compared to younger people. CD4+ counts rose from 212 cells to 289 cells after 12 months of therapy in older people. In the group of younger people, CD4+ counts rose from 231 cells to 345 cells during the same time.
Left unexplored in this study is the impact of HAART on an aging body and its complications, including the following:
1. Manfredi R and Chiodo F. A case-control study of virological and immunological effects of highly active antiretroviral therapy in HIV-infected patients with advanced age. AIDS 2000;14(10):1475-1477.
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