HIV and aging: time for a new paradigm.
HIV and aging: time for a new paradigm.
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DOI：
10.1007/s11904-010-0041-9
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发表时间：
2010-05-01
影响因子：
4.6
通讯作者：
Justice, Amy C
中科院分区：
文献类型：
--
作者：
Justice, Amy C
通过联合抗逆转录病毒治疗实现病毒抑制的艾滋病毒感染患者群体正在增长、老龄化，并经历着非艾滋病疾病谱的扩大。与此同时，艾滋病的定义条件越来越不常见，并与结果无关。尽管如此，艾滋病毒感染者所经历的疾病谱仍然受到艾滋病毒、其治疗以及与艾滋病毒感染相关的行为、状况和人口统计学的强烈影响。我们的重点必须从对CD 4计数、HIV-RNA和艾滋病定义性疾病的狭隘兴趣转向确定艾滋病毒感染的最佳管理，因为艾滋病毒感染是一种复杂的慢性疾病，其发病和死亡原因是多种多样和重叠的。我们需要一种新的护理模式，以最大限度地提高功能状态，最大限度地减少虚弱，并延长预期寿命。一个综合指数，总结病人的发病率和死亡率的风险，可以促进这项工作，并帮助图表的进展。
The population of patients with HIV infection achieving viral suppression on combination antiretroviral therapy is growing, aging, and experiencing a widening spectrum of non-AIDS diseases. Concurrently, AIDS-defining conditions are becoming less common and are variably associated with outcome. Nonetheless, the spectrum of disease experienced by those aging with HIV remains strongly influenced by HIV, its treatment, and the behaviors, conditions, and demographics associated with HIV infection. Our focus must shift from a narrow interest in CD4 counts, HIV-RNA, and AIDS-defining illnesses to determining the optimal management of HIV infection as a complex chronic disease in which the causes of morbidity and mortality are multiple and overlapping. We need a new paradigm of care with which to maximize functional status, minimize frailty, and prolong life expectancy. A composite index that summarizes a patient's risk of morbidity and mortality could facilitate this work and help chart its progress.