HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group.
HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group.
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DOI：
10.1097/qai.0b013e31825a3668
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发表时间：
2012-07-01
期刊：
影响因子：
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通讯作者：
OAR Working Group on HIV and Aging
中科院分区：
文献类型：
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作者：
High KP;Brennan-Ing M;Clifford DB;Cohen MH;Currier J;Deeks SG;Deren S;Effros RB;Gebo K;Goronzy JJ;Justice AC;Landay A;Levin J;Miotti PG;Munk RJ;Nass H;Rinaldo CR Jr;Shlipak MG;Tracy R;Valcour V;Vance DE;Walston JD;Volberding P;OAR Working Group on HIV and Aging
艾滋病毒危险行为、对艾滋病毒感染的易感性、感染后的疾病进展以及对抗逆转录病毒治疗的反应都因年龄而异。在艾滋病毒携带者中，目前有效的治疗已将预期寿命的中位数提高到70岁。随着艾滋病毒感染年龄的增长，生物、医学、个人社会和社会问题也会发生变化，但在这一领域只有少量的研究。因此，美国国立卫生研究院艾滋病研究办公室委托一个工作组制定一份关于艾滋病毒和老龄化研究的知识现状和迫切需要的领域的概要；工作组的调查结果和建议摘要载于本报告。该小组确定的主要主题包括：多发病、多药物和需要强调维持功能；评估艾滋病毒与治疗效果、老龄化与并发疾病的复杂性；免疫衰老、炎症和高凝状态的相互关联机制；多变量指数用于预测结果的实用性；需要强调人体研究以考虑复杂性；以及需要关注社区支持、照顾者和系统基础设施问题。制定这一研究议程需要关键资源，包括扩大审查小组在老龄化、功能措施和多种发病率方面的专门知识，以及促进使用和继续提供资金，以便对艾滋病毒老龄化队列进行长期跟踪。
HIV risk behaviors, susceptibility to HIV acquisition, progression of disease after infection, and response to anti-retroviral therapy all vary by age. In those living with HIV, current effective treatment has increased the median life expectancy to > 70 years of age. Biologic, medical, individual social and societal issues change as one ages with HIV infection, but there has been only a small amount of research in this field. Therefore, the Office of AIDS Research of the National Institutes of Health commissioned a working group to develop an outline of the current state of knowledge and areas of critical need for research in HIV and Aging; the working groups’ findings and recommendations are summarized in this report. Key overarching themes identified by the group included: multi-morbidity, poly-pharmacy and the need to emphasize maintenance of function; the complexity of assessing HIV vs. treatment effects vs. aging vs. concurrent disease; the inter-related mechanisms of immune senescence, inflammation and hypercoagulability; the utility of multi-variable indices for predicting outcomes; a need to emphasize human studies to account for complexity; and a required focus on issues of community support, caregivers and systems infrastructure. Critical resources are needed to enact this research agenda and include expanded review panel expertise in aging, functional measures and multi-morbidity, as well as facilitated use and continued funding to allow long-term follow-up of cohorts aging with HIV.