The HIV and Aging Consensus Project: Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV

The American Academy of HIV Medicine (AAHIVM), the American Geriatrics Society (AGS) and the AIDS Community Research Initiative of America (ACRIA) has released the first clinical treatment strategies for managing older HIV patients: The HIV and Aging Consensus Project: Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV.

View the executive summary of the report or download the entire report.

The Expert Panel members and other participants in the HIV & Aging Consensus Project also invite you to join the interactive discussion forum to become actively involved in advancing the knowledge and communication in this area of medical uncertainty.

The report is part of the organizations’ HIV and Aging Consensus Project, developed to assess how the presence of both HIV and common age-associated diseases, alter the optimal treatment of HIV as well as other co-morbidities. The purpose of the report, developed by a panel of experts with experience both in the fields of HIV and Geriatrics, is to provide best practice guidance for HIV practitioners and other health care providers who treat, diagnose and refer older patients with HIV disease. 

New Clinical Report Provides the First-Ever
Recommended Treatment Strategies for Older HIV Patients

American Academy of HIV Medicine, American Geriatrics Society and the AIDS Community Research Initiative of America Release Best Practices for
Managing Multi-Morbidity

Washington, DC:  On the eve of World AIDS Day, the American Academy of HIV Medicine (AAHIVM), the American Geriatrics Society (AGS) and the AIDS Community Research Initiative of America (ACRIA)  released the first clinical treatment strategies for managing older HIV patients: The HIV and Aging Consensus Project: Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV.

The report is part of the organizations’ HIV and Aging Consensus Project, developed to assess how the presence of both HIV and common age-associated diseases, alter the optimal treatment of HIV as well as other co-morbidities. The purpose of the report, developed by a panel of experts with experience both in the fields of HIV and Geriatrics, is to provide best practice guidance for HIV practitioners and other health care  providers who treat, diagnose and refer older patients with HIV disease.

In 2006, 26 percent of HIV-infected adults in the U.S. were at least age 50, and in 2011 estimates place that number at almost 40 percent. The most recent data from the Centers for Disease Control and Prevention (CDC) shows that individuals in that age group accounted for 17 percent of all new HIV diagnoses each year.

“This will be a valuable reference resource, an informed  guide for the physician who has HIV patients manifesting multiple age-related diseases and is not sure how best to approach such challenges,” said Jonathan Appelbaum, MD, AAHIVS, co-leader of the study project and Director of Internal Medical Education at Florida State University College of Medicine.

“It gives the HIV clinician who has a patient with multiple medical conditions something to go on,” noted project co-leader Wayne McCormick, M.D., MPH, a professor of geriatric medicine at the University of Washington’s Division of Gerontology and Geriatric Medicine in Seattle. “There is so much we don’t know about older people with HIV. This is an effort to begin to help.”

The report represents a two-year collaboration among members of AAHIVM, AGS, and ACRIA regarding the clinical management of HIV-infected older persons.  As the lines of communication have grown between HIV providers and geriatricians, common themes have emerged regarding the care of HIV-infected older adults.   Recognizing the lack of information from clinical studies pertinent to the care of these older individuals, an Expert Panel was formed in 2009 to formulate clinical treatment approaches to these patients.

The Expert Panel reached consensus on treatment strategies in the following categories:

• Screening, Monitoring, and Initiating Antiretroviral Therapy in HIV and Aging

• Cardiovascular Risk Reduction, Diabetes in HIV and Aging

• Monitoring Renal Function / Hypertension in HIV and Aging

• Drug-drug Interactions and Polypharmacy in HIV and Aging

• Viral Hepatitis Screening in HIV and Aging

• Cancer Screening in HIV and Aging

• COPD in HIV and Aging

• Immunizations in HIV and Aging

• Sexual Health in HIV and Aging

• Osteoporosis in HIV and Aging

• Advance Directives in HIV and Aging

• Neuro-cognitive Changes, Psychiatric Illness and Substance Use in HIV and Aging

The Panel adopted the convention that the term “older”, in the context of persons with HIV infection, pertained to age 50 or greater.   The composition of the Panel was made up of equal proportions of experts with expertise in geriatrics and those with expertise in HIV medicine (7 each).  Many panelists are acknowledged leaders in research at major academic institutions and practices settings across the country.

To access the entire report, the executive summary or for a full list of the panel members, please visit the AAHIVM website at http://www.aahivm.org/hivandagingforum.  The Expert Panel members and other participants in the HIV & Aging Consensus Project also invite interested readers to visit this site to become actively involved in advancing the knowledge and communication in this area of medical uncertainty.  The Panel is most hopeful that as more medical knowledge becomes available from observational studies and clinical trials, the care of HIV-infected patients over age 50 can be more evidence-based.  Because this area of interest is rapidly evolving, with new information coming forth weekly, the results of the Panel’s work now appears in a discussion forum format at www.aahivm.org/hivandagingforum.

The HIV and Aging Consensus Project was made possible through generous support from Tibotec (now Janssen Pharmaceuticals), Strativa Pharmaceuticals, and the Campbell Foundation, awarded to the American Academy of HIV Medicine to administer this program.
To arrange an interview with one of the Expert Panel members or representatives from AAHIVM, AGS, and ACRIA, please contact Amber McCracken at 703-599-0134 or amber@aahivm.org