Over the hill with HIV!

By:Maria Lawrynowicz

Supervised by: Gilbert Mallais (Treatment Information Facilitator)

Thanks to the incredible advances in HAART treatment during the last 30 years, those living with HIV have a much higher life expectancy and improved quality of life. This has created a relatively new area of research interest that was unheard of just 20 years ago: aging with HIV. How does infection with HIV change the progression of the normal biological processes and associated pathologies that come with aging? Research into this domain is complex because it is difficult to track subjects over long periods of time. This study, however, not only looked at 1046 HIV+ patients in France who began treatment with anti-retroviral between 1997-1999, but also followed them for 10 years!! More studies should follow this lead because in the HIV+ community, it is no longer a question of worrying IF you make it “over-the-hill”, but WHAT you will do when you get there.

Ten-year diabetes incidence in 1046 HIV+ patients started on a combination antiretroviral treatment

AIDS volume 16(30) 28 January 2012 p303-314

Capeau, Jacqueline; Bouteloup, Vincent; Katlama, Christine;Bastard, Jean-Philippe; Guiyedi, Vincent; Salmon-Ceron, Dominique;Protopopescu, Camelia; Leport, Catherine; Raffi, Francois; Chêne, Geneviève

The late 90s saw an increase in diagnosis of type II diabetes in the HIV+ community. When tested, the patients lacked certain classic risk factors for diabetes such as, high blood pressure, family history, or hepatitis C infection; however, as testing continued several pattern emerged. Researchers found that the patients who received first generation protease inhibitors such as stavudine, indinavir, or didanosine had a higher chance (12.6% in women; 14.6% in men*) of developing diabetes. Interestingly enough, this trend was restricted to those with short term exposure to the drugs (likely because those who developed diabetes ceased treatment shortly after). Since then the drugs have been taken off the market in the West and are no longer used; however, in most cases, the diabetes persisted even after the treatment was halted.

More importantly, however, the study noted that age and fat content were found to be the best markers for diabetes, even better than the use of the first generation PIs. Due to the changes in fat distribution that occur with HIV, the HIV+ community must be vigilant of risk factors for diabetes and maintain a healthy lifestyle as it ages. HIV+ individuals should also have annual checkups to test fasting glycaemia and fat parameters, such as BMI and waist: hip ratio. Early detection of risk factors may allow patients to make simple lifestyle changes before having to revolutionize their lives with another complicated disease. As the saying goes, the grass is always greener on the other side, so keep your body in the best shape on the way there!

*[Keep in mind that this study was done in Europe. Had this study been done in North America, the results would likely be even more startling.]