Older patients (>50 years of age) should be initiated on treatment as soon as possible after diagnosis because this population:

Experiences accelerated CD4 loss

Has decreased immune recovery

Is at increased risk of serious non-AIDS illnesses

As people age, they typically have more comorbidities, take more medications, and are more vulnerable to side effects—complicating management of their disease.

Age-associated noncommunicable comorbidities (including hypertension, myocardial infarction, and peripheral artery disease) were numerically more prevalent among people living with HIV than HIV-uninfected controls 5

Aging people with HIV often develop inflammation and cardiovascular, kidney, liver, bone, and neurologic disease 6.8

Potential side effects and drug-drug interactions for aging-associated comorbidities can further complicate ART management1

People who acquire resistance to one or more antiretroviral (ARV) drugs as they age limit their available treatment options if they develop virologic failure in the future.