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Aging with HIV Clinical and Biological Realities in the Democratic Republic of Congo

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by

Vishnu
in

Introduction

In the era of antiretroviral therapy (HAART), life expectancy for people living with HIV (PLWHIV) has significantly increased. However, with this extended longevity comes a new challenge: the clinical and biological complications of aging with HIV. A recent study conducted at Kinshasa University Teaching Hospital sheds light on this issue, comparing health profiles of PLWHIVs aged 50 and older with those under 50.
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Study Overview and Objectives

The study evaluated 270 patients over a six-year period. It aimed to identify clinical signs, comorbidities, and biological variances between two age groups:

  • Under 50 years
  • 50 years and older

The goal was to highlight age-specific health needs of aging PLWHIVs and the pressures they pose on under-resourced healthcare systems like that of the Democratic Republic of Congo.

Key Finding

Demographic Snapshot:

  • 35.1% of PLWHIVs were aged 50+.
  • Female predominance was observed in the <50 group (71.4%), while men were more prevalent in the 50+ group (52.6%).
  • Primary education and low socioeconomic status were more common in older patients.

Clinical Characteristics:

  • Patients aged 50+ were significantly more likely to be in WHO Stage 4 of HIV.
  • Higher prevalence of:
    • Tuberculosis (TB) (31.6%)
    • Hypertension
    • Anemia
    • Genital herpes
    • Tobacco use

Patients under 50 had a greater incidence of:

  • Hepatitis B and C
  • Shingles
  • Headaches

Biological Profile:

  • Older adults had significantly:
    • Lower hemoglobin (Hb), HDL-C, and CD4+ levels
    • Higher levels of urea, LDL-C, and ALAT (a marker of liver damage)

Vital Outcomes:

  • While survival was higher in patients under 50, the difference was not statistically significant.

Broader Implications

According to the Centers for Disease Control and Prevention (CDC), nearly 50% of HIV diagnoses in the USA now occur in people over 50, mirroring the trends seen in this Congolese cohort. This signals a growing need for geriatric HIV care and targeted strategies for managing comorbidities such as TB, cardiovascular diseases, and cognitive decline.

Further Reading and Resources

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