HIV and ageing – HIV increases likelihood of cataract surgery
Cataracts are cloudy patches that develop on the lens of the eye. Ageing can cause them, as can the inflammation caused by infections. Long-term use of certain kinds of steroids is another possible cause.
Danish researchers looked at rates of cataract surgery in over 5000 HIV-positive people. Each person was matched with ten HIV-negative people of the same sex and age from the general population. This allowed the researchers to see if rates of surgery were higher in those with HIV.
Overall, 1.7% of people with HIV had cataract surgery, compared to 1.4% of the control group. The researchers therefore calculated that people with HIV were 87% more likely to need cataract surgery.
In addition, 5% of the HIV-positive people (compared to 1% of the control group) had eye disease that can increase the risk of cataracts.
The researchers are uncertain why people with HIV have an increased risk of cataracts.
But a CD4 cell count below 200 increased the risk, and they also speculate that cataracts may be a side-effect of HIV treatment.
However, because HIV has been associated with an increased risk of cardiovascular disease and other diseases of ageing, the investigators conclude, “accelerated aging in the HIV-infected population cannot be excluded as a possible part of the explanation.”
You can find more information on cataracts on the NHS Choices website: www.nhs.uk/conditions/Cataracts-age-related
HIV and employment – some conditions increase risk of unemployment
French doctors looked at rates of employment in people with HIV in the first five years after their diagnosis. The researchers wished to establish if HIV or any other illnesses increased the risk of unemployment.
Their study focused on 367 people who had a job at the time of their diagnosis with HIV.
Over the five years of the study, 67 people left work before the official French retirement age of 60.
They included 58 people who became unemployed, four who were medically retired, three who took long-term sick-leave and two who returned to education or undertook further training.
The researchers noted that 24 people went back to work. However, at the end of the study 47 people (13% of the study population) were still out of work.
Diabetes, high blood pressure (hypertension) and, to some extent depression, all increased the risk of leaving work.
However, there was no evidence that CD4 cell count or viral load were associated with leaving employment. Nor did starting HIV treatment increase the risk.
“The risk of work cessation during the course of HIV infection has remained substantial,” the investigators conclude. “Particular attention should be paid to prevent HIV-infected patients affected by comorbidities [other diseases] from leaving employment.”
For more information on HIV & employment, visit the Employment topics page.
Testosterone treatment increases chances of blood disorder
This over-production of red blood cells is called polycythaemia. It can increase the risk of blood clots and cardiovascular problems. The risks are greatest for people with diabetes or high blood pressure. Other problems associated with the condition include headache, blurry vision and feeling confused.
A well-known side-effect of testosterone replacement therapy is the over-production of red blood cells.
Researchers wanted to see if testosterone treatment also caused the condition in people with HIV.
A total of 6000 people who received care over ten years were included in the study.
Rates of the condition were very low. Only 25 (0.42%) developed polycythaemia. A total of 21 of these patients were men, and the researchers focused their attention on these individuals.
Testosterone replacement therapy was used by two-thirds of the men with over-production of red blood cells compared to a fifth of those who did not develop polycythaemia.
The researchers therefore recommend that HIV-positive people taking testosterone replacement therapy should have regular tests to monitor their red blood cell count with “adjustment of testosterone dose or cessation of therapy as appropriate…patients with polycythaemia should be queried about prescription or non-prescription use of testosterone.”