The introduction of protease inhibitors and drug cocktails in the 1990s meant that AIDS patients could live longer than ever thought.
Before 1996, when new drugs were rolled out, life expectancy was 18 months post-diagnosis. Now, AIDS patients regularly live decades with the disease. But as these patients live longer, unanticipated side effects — caused by the disease itself, medications to treat it or both — introduce a new set of maladies.
David France, a contributing editor at New York Magazine, was motivated to write a story on AIDS-related aging after noticing that a number of his friends with the disease were having what he describes as cognitive issues.
"[They were] forgetting things, forgetting appointments, forgetting whole conversations," France told NPR's Steve Inskeep.
Researchers are finding that patients who live longer with AIDS also begin to suffer from osteoporosis, various forms of cancer, kidney disease and cardiovascular disease.
"[It] makes them seem 25 years older than they are," said France, who believes some of the medications used to treat the disease may cause these problems.
Joe Westmoreland has suffered from this type of early aging. He was diagnosed with HIV in 1982. In 1995, he was diagnosed with AIDS. Before then, he was fairly healthy.
His AIDS diagnosis came just before new drugs were released. He was one of the first to use the medications. After starting on them, his T cells began rising — the drugs worked.
But as time went on, he got sick. Westmoreland began suffering from neuropathy, a type of nerve damage that can occur in the feet. It later spread to his hands. He started showing signs of osteopenia, a less advanced type of osteoporosis. Then came forgetfulness. But Westmoreland didn't think much of it.
"I've taken a lot of this stuff for granted," said Westmoreland, who is in his early 50s. "Just par for the course."
Blame The Drugs Or The Disease?
Researchers still don't know what to blame for symptoms like Westmoreland's — AIDS or the drugs used to treat it. Most experts assume that the drugs cause neuropathy. Many others are starting to believe that those drugs cause bone loss, as well.
France sees many new questions raised by this emerging crisis.
"The question now is why don't we have more drugs, less toxic drugs?" he asked. "Where is AIDS activism? Why aren't the people with HIV themselves organizing to call for research into the next frontline medications?"
But the reality of people living longer with the disease lessens the urgency, and deciding what to do with American resources to fight AIDS has become an issue that crosses the globe.
"The energy for AIDS activism and AIDS thinking has moved globally," France said. "[It] has taken the spotlight off the ongoing [domestic] epidemic clinically.
"What is AIDS today?" France asked. "And are we finished thinking about how to take care of it today?"
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