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Virawudh Soontornniyomkij

and Cristian L. Achim

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date: 07 July 2020

Dramatically improved survival due to HAART, and increases in newly diagnosed HIV infection in older adults, have lead to a growing number of older HIV+ patients. In the United States, it has been estimated that 50% of individuals living with HIV will be 50 years old or older by 2015. Chronic comorbid conditions that are not specifically related to HIV are more common in older HIV+ adults than in their younger counterparts and chronic medication use for these conditions raises the risk of drug-drug interactions with HAART regimens. HIV-associated neurocognitive disorders (HAND) continue to affect the clinical outcome of HIV infection, even in the context of systemic viral suppression. Increasing evidence has suggested that HAND in older adults in the HAART era represent "deficits of multiple etiologies," including brain HIV variants, aging-related cerebrovascular and neurodegenerative changes, chronic adverse effects of antiretroviral drugs, and other comorbid factors. This chapter surveys the complex interactions of HIV positivity and aging as it affects the development of HAND.

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