"Martin" <martin@hiv-poz.co.uk> wrote in message

 AIDS patients face an array of disorders as they live longer Adam Doster
Published: Saturday January 5, 2008

Antiretroviral drugs, made popular at the height of the AIDS epidemic,
gave thousands of H.I.V. patients a new lease on life. But at what cost?

That is a question scientists, doctors, and patients are now considering as
the first wave of AIDS survivors to reach late middle age are encountering
an array of disorders -- prematurely or in disproportionate numbers --
usually associated with aging.

According to the New York Times, "there have been only small, inconclusive
studies on the causes of aging-related health problems among AIDS
patients." But few experts believe that the trends are coincidental.

Instead, those in the medical field are beginning to think that prior to
the development of antiretroviral drugs, the immune systems and organs of
long-term patients "took an irreversible beating." And because of their
toxicity, the very drugs supposed to protect H.I.V. patients produced
supplementary complications.

Take John Holloway of Chicago, who received a diagnosis of AIDS nearly two
decades ago. Thanks to medication, he's still alive at age 59, but the
longevity has brought an array of unanticipated conditions, including
chronic obstructive pulmonary disease, diabetes, kidney failure, a bleeding
ulcer, severe depression, rectal cancer and the lingering effects of a
broken hip. Many of these are complex and difficult to treat.

"AIDS is a very serious disease, but longtime survivors have come to grips
with it," said Dr. Charles A. Emlet, an associate professor at the
University of Washington at Tacoma and a leading H.I.V. and aging
researcher. "Then all of a sudden they are bombarded with a whole new round
of insults, which complicate their medical regime and have the potential of
being life threatening. That undermines their sense of stability and makes
it much more difficult to adjust."

Dr. Sheree Starrett, the medical director at Rivington House, a residence
for AIDS patients on the Manhattan's Lower East Side, gave the example of
heart disease and diabetes, which are not "terribly hard to treat, except
that every time you add more meds there is more chance of something else
going wrong."

Given that no research on the connections has been conclusive, patient's
care is often limited as well. Medicare, Medicaid and private insurers will
often neglect to cover necessary procedures.

The "graying of the AIDS epidemic" has raised interest in the connection
between AIDS and certain cancers, diabetes, osteoporosis and depression.
From 2001 to 2005, the number of people 50 and older living with H.I.V. has
increased 77 percent, according to the federal Centers for Disease Control.
They now represent more than a quarter of all cases in the United States.