The Challenge of Treating HIV and Comorbidities

Segment Description: W. David Hardy, MD, adjunct professor of medicine in the Division of Infectious Disease at Johns Hopkins University, talks about the challenges in treating patients with HIV and comorbidities.

Interview transcript (modified slightly for readability):

Contagion®: What are the biggest challenges for providers in treating HIV patients with comorbidities?

W. David Hardy, MD: The reason that our patients are having an increased number of comorbidities is really because they're living longer and they're getting old and they are having the same sort of medical progression that all human beings have. In many ways this is a great thing because back in the ’80s and ’90s our patients didn't live very long. They didn't live long enough to get heart disease, brain disease, kidney disease, or all those sorts of things and now they do. So as people are getting older, and it's estimated that over 50% of all HIV-positive persons are now over 50, we are dealing with lots of other sort of usual sort of health care problems that occur and everyone else.

The difference is they seem to occur at a higher percentage of people at a younger age if someone's HIV positive. Is this what some people try to call premature aging or advanced aging? Don't think so, but there's probably something that is causing an increased incidence of heart disease, kidney disease, liver disease, especially those who have hepatitis B or C, and some neurocognitive disease as well. These are very important diseases as people continue to live with HIV with suppressed on their HIV medications over time and they have become a very important part of active HIV research because this is really what I like to call the second generation of HIV research. Now we have people suppressed. What's going to happen to them in the future? Every indication is is they are going to have more comorbidities [so] how do we deal with those in a better way?