News / Vancouver

'It's a good problem to have': HIV patients face age-related ailments

The BC Centre for Excellence in HIV/AIDS is launching a new initiative that aims to maximize the longevity of people living with HIV.

Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS.

Jennifer Gauthier/Metro File

Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS.

Two decades ago, Dr. Julio Montaner’s biggest concern for people with HIV was keeping them alive.

Today, the director of the BC Centre for Excellence in HIV/AIDS says he is grateful to be treating HIV-positive patients with age-related ailments. 

“It’s a good problem to have,” he told Metro. “I was always hopeful and optimistic that one day we were going to find a way to deal with this issue better than when all of this started. Those were very devastating days. Today, not only are we talking about stopping people from getting AIDS, but we’re talking about them having families and allowing them to live a normal life.”

To coincide with World AIDS Day on Tuesday, the BC Centre for Excellence in HIV/AIDS is launching Healthy Aging With HIV, an initiative that aims to better understand how to maximize the longevity of people living with HIV. The Vancouver-based partnership will bring together physicians and specialists from a range of disciplines to share information on the best ways to treat HIV patients as they age.

Once considered a death sentence, HIV is now viewed as a chronic manageable condition. In 1996, the life expectancy for a 20-year-old diagnosed with HIV was about a decade. Today, a 20-year-old diagnosed with recently acquired HIV infection who immediately starts antiretroviral therapy will see a life expectancy of another 50 years of near-normal quality.

With HIV patients living longer, Montaner said doctors are seeing an increase in patients getting sick or dying of non-AIDS-related health issues, mainly liver disease, often due to hepatitis C infection, cardiac disease and chronic obstructive pulmonary disease.

Montaner said there is some indication that HIV itself may affect biological aging. He said doctors are seeing higher rates of emphysema in people with HIV.

Patients who survived the “first wave” of antiretroviral drugs, which has been associated with kidney disease among other health problems, also have a “higher challenge of leading a healthy life into their 60s or 70s," said Montaner.

“People who acquired HIV more recently are not exposed to those first generation drugs and have a better quality of life ahead of them,” he said. “Still we feel that they need to be careful. Any amount of HIV can accelerate your aging process.”

Still, Montaner said the treatment has come a long way since 1996 when, at an AIDS conference held in Vancouver, he first announced the discovery of HAART, or highly active antiretroviral therapy.

Since then, HAART has become the standard of care for HIV around the world and deaths from the disease have plummeted.

Montaner said he recently had a 91-year-old patient who died of complications from a hip fracture.

“He was HIV positive and I’m happy to tell you that HIV was never a problem for him,” he said. “He was one of the healthiest and happiest people I knew.”

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