HIV ageing, comorbidities and the brain
HIV ageing, comorbidities, and models of care
Increased life expectancy in people living with HIV has brought the challenges of ageing and comorbidities to HIV clinical care. Our aim is to advance knowledge and practice to improve the management of ageing people living with HIV affected by frailty and comorbidities. Our work focuses on the study of comorbidities affecting people with HIV and the development and evaluation of innovative models of care to improve the management of ageing people with HIV.
HIV and the Brain
Our research aims to understand the mechanisms associated with the development of cognitive and neuropsychiatric symptoms in people with HIV using brain imaging techniques and biomarkers. We also have a research interest in developing models of care and interventions to improve the quality of life of people with HIV and cognitive impairment. One such initiative is the Orange Clinic in Brighton – a specialist HIV memory service providing diagnosis and management for individuals experiences these issues.
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Chain UKI
CHAIN UKI (Care of HIV and Ageing Implementation Network UK and Ireland) is a dedicated working group focused on optimising care for older people living with HIV and advancing research in the field. Our mission is to enhance the healthcare outcomes for this population through identifying research priorities, defining effective and collaborative care models, and encouraging implementation of best practices.
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PEARL study
Older aldults are often under-represented in the randomised clinical trials that inform treatment policy. Comorbidities including kidney and bone disease, sleep disruption and mood distrubance can become more prevalent in later life and affects the choice of antiretroviral therapy, however currently there is limited evidence and guidance specifically for this population. The PEARL study (Perimenopause and Older Adults with HIV: Treatment Outcomes and Lived Experience) is an multi-site observational cohort study that seeks to understand the experiences, choices and clinical outcomes in relation to antiretroviral therapy (bictarvy/emtricitibine/tenofavir alafenamide fumarate) in mid and later stages of life.
Effectiveness of interventions to reduce risk of cognitive decline in people living with HIV: evidence synthesis for the World Health Organisation guidelines
This project was funded by the World Health Organisation.
As people living with HIV are living longer thanks to effective antiretroviral therapy, there is increasing interest in how to reduce the risk of cognitive decline and dementia in this population. People ageing with HIV have higher rates of cardiovascular disease, mental health conditions, sleep problems, and other factors that may affect brain health, yet there is limited evidence on which interventions may help reduce the risk of cognitive impairment.
Professor Jaime Vera contributed to an evidence synthesis commissioned by the World Health Organisation to inform the update of the WHO guidelines on risk reduction of cognitive decline and dementia. The review examined the effectiveness of interventions aimed at reducing the risk of cognitive decline in people living with HIV who are receiving antiretroviral therapy.
The research question addressed whether in addition to pharmacological interventions, lifestyle, medical, or behavioural interventions are effective in preventing or delaying cognitive decline in adults living with HIV with normal cognition or mild cognitive impairment.
The project reviewed and synthesised the available scientific evidence to support guideline development. This work is helping inform the next version of the WHO recommendations on dementia risk reduction, which for the first time will include specific considerations for people living with HIV.