[Premature aging in human immunodeficiency virus (HIV) infected patients: detection, pathophysiological mechanisms and management].

Most patients diagnosed with human immunodeficiency virus (HIV) infection now receive effective treatment. However, as the HIV-infected population gets older, manifestations of aging is starting to emerge 10-15 years earlier than in the general population, such as cardiovascular disease, osteoporosis, neurocognitive disorders, metabolic complications, and kidney and liver failure. Clinical studies suggest that the pathophysiology of this premature aging may be multifactorial. In addition to residual HIV infection, immune activation (leading to immunodeficiency) and some antiretrovirals might contribute to low-grade systemic inflammation that could drive tissue senescence and provoke degenerative and proliferative disorders. Management of these patients involves lifestyle modifications and switching from first-generation antiretrovirals towards less toxic drugs. Antiinflammatory treatment could be considered for at-risk patients.