HIV and AIDS Current Topics in HIV and AIDS

Living with AIDS, but Dying of Other Things: A New Perspective on HIV Care

More people with AIDS are dying of causes other than HIV than in years past, reports a new study of New York City AIDS patients.

It may not seem like a significant statistic, but the recent findings, published in the Annals of Internal Medicine, may signal the need for a change in the way HIV and AIDS patients receive care.

The study included data from over 68,000 New Yorkers with AIDS aged 13 or older. The researchers found that between 1999 and 2004, the number of people with AIDS who died from non-HIV-related causes increased by almost 33 percent, while the number of people who died from HIV-related causes dropped significantly.

Dr. Judith Aberg, in an editorial accompanying the study, explains that these findings indicate that new HIV treatments have turned HIV from a short-term disease into a chronic one, where the disease can be kept at bay for many years.

In the meantime, other, more common causes of death tend to creep up on an AIDS patient. These include cardiovascular disease, cancer and substance abuse, many of the same diseases that are the top causes of death for the general population.

This is of particular significance when one considers that a patient with AIDS tends to see an HIV specialist rather than a general practitioner. These doctors have made great strides in treating HIV and managing the side effects of HIV-medications, but may not have as much knowledge about heart disease and cancer, says Aberg.

“Physicians everywhere must remembers that most of their HIV-infected patients will survive to develop the diseases that plague the rest of us,” writes Aberg.

This would represent a major shift from how HIV has been managed for the past 25 years. Since patients are now living so much longer with AIDS, they need to be sure to add to their medical care the same screening tests and procedures that the general population receives.

“This includes helping patients change behaviors, such as smoking, screening for early detection of cancer and monitoring chronic disease, such as diabetes and hypertension,” said Dr. Judith Sackoff, lead author of the study.