1. Adhere to your meds
Taking your antiretrovirals as prescribed and maintaining an undetectable viral load not only help protect your immune system but also prevent transmission of the virus. What’s more, fully suppressing HIV helps reduce chronic inflammation, which is associated with various negative health outcomes, such as cardiovascular disease.
For those who have multidrug-resistant HIV, the biweekly injectable antibody Trogarzo (ibalizumab) hit the market in 2018. In addition, the investigational attachment inhibitor fostemsavir recently performed well in a clinical trial.
2. Quit smoking
Two medications can help you kick cigarettes to the curb: Chantix (varenicline) and Zyban (bupropion). Complementing such treatment with smoking-cessation behavioral counseling may boost your chances of success.
If you use e-cigarettes, it’s important to note that there has been an outbreak of severe lung illness among users, including several deaths. The Centers for Disease Control and Prevention (CDC) has recommended that people abstain from vaping until investigations into the cause of this outbreak can be conducted. In particular, the CDC has advised against using bootleg vaping products, including those containing THC, the active ingredient in marijuana.
3. Treat viral hepatitis
Hepatitis B virus is treatable with medications such as Vemlidy (tenofovir alafenamide) and Baraclude (entecavir). Hepatitis C virus is now readily curable with a number of well-tolerated regimens—typically taken for just six to 12 weeks.
4. Control alcohol use
Three or more daily drinks for women and four or more for men is considered heavy drinking and is associated with health problems.
For those with hep B or C, physicians tend to advise totally avoiding alcohol because of its potential harm to the liver.
Many heavy drinkers have benefited from programs such as Alcoholics Anonymous and
SMART Recovery. In a recent study, monthly injections of extended-release naltrexone helped HIV-positive heavy drinkers cut back.
5. Abstain from drugs
Three meds are available to help those with opioid use disorder: methadone, buprenorphine and naltrexone. Counseling and abstinence-based programs, such as Narcotics Anonymous, are other options.
6. Get regular checkups
These days, keeping HIV well controlled may require seeing a doctor only twice per year. But as you age, you may need to see health care providers more frequently. Clinicians should assess cancer risk, cardiovascular disease, bone loss, mental health and quality of life; they should also provide any necessary vaccines, including boosters. Routine testing for hep B and C and for sexually transmitted infections is recommended.
7. See a geriatric physician and other specialists
Ideally, medical care for older people with HIV should involve a team that includes various specialists, including geriatricians. In particular, clinicians should assess physical function, frailty and nutrition and ask about falls, incontinence, sleep disorders, vision and hearing problems, confusion and aging-related muscle loss.
8. Eat well
Research involving HIV-negative people with a high risk for cardiovascular disease shows that the Mediterranean diet is associated with a lower risk of heart attack, stroke and death. Eating plenty of lean protein helps maintain muscle mass, while highly processed food is associated with a shorter life span.
Maintaining a healthy body weight can help reduce the risk of cardiovascular disease, including by lowering blood pressure and preventing diabetes. A healthy weight also lowers cancer risk. Strength training can help ward off aging-related muscle decline. Aerobic exercise may mitigate depression in people with HIV. Staying active can also help prevent frailty.
10. Maintain your mental health
Seeing a mental health professional and possibly taking medication to treat conditions such as depression and anxiety can help not only with mental health but also with overall health. Reducing social isolation is another vital step for people aging with HIV.