Your liver is a great multitasker, filtering your blood, detoxifying chemicals, aiding food and drug metabolism and helping your blood to clot so that wounds heal more quickly. As you get older, the liver’s work rate slows, making it less efficient at cleaning your blood. If you have HIV – and especially if you also have hepatitis B or C – your liver is likely to struggle further, becoming less able to do its vital work and more prone to disease.
Given the increased likelihood of liver-damaging infections and the use of medicines by people with HIV, routine blood tests to check on liver function, and screening for hepatitis B and C are highly recommended. People living with HIV can also give their liver a helping hand by avoiding fatty foods, excessive alcohol consumption and recreational drugs.
There’s nothing quite like a broken bone to put dampeners on your travel plans, but research shows that people living with HIV may have lower bone mineral density than the general population and are nearly five times more likely than others to suffer a hip fracture.1 This is why it’s important to keep an eye on your bone health and consult your doctor if you have any worries, to ensure you can spot any avoidable issues before they get worse.
The relationship between HIV and cancer? Well…it’s complicated. People with HIV are more likely to get some cancers, such as anal, liver, Hodgkin’s lymphoma, Kaposi’s sarcoma and mouth cancers.
Lifestyle factors such as smoking and drinking too much alcohol contribute to about 24% of all cancers and some of the increased cancer risk among people with HIV could be linked to these factors.2 Also, there is an increased likelihood of people with HIV having viral infections that can increase the risk of certain cancers, such as human papilloma virus (HPV) and hepatitis C (HCV) infection.
While much about the links between HIV and cancer remains unknown, it’s clear that in most cases, cancer is a disease of ageing, with the majority (78%) of cancers diagnosed in people aged 55 and older.3 It follows that as people with HIV live longer, their risk of cancers linked to ageing is also likely to increase. Regular cancer screening – including for cervical, breast, bowel and prostate cancer – is recommended for everyone, not only people living with HIV. We are still discovering more about the links between HIV and cancer. Talking to your care team about your risks and how to reduce them is important.
The kidneys may not be glamorous, but they’re real grafters, working night and day to filter out waste products from your body and regulate blood pressure. Unfortunately people living with HIV have an increased risk of kidney disease. This is partly due to hypertension and diabetes (the two main causes of kidney disease) being common among people with HIV, but the risk can also be increased by long term exposure to recreational drugs, hepatitis B and C infections, and some of the medicines used to treat HIV. Unfortunately, kidney disease symptoms don’t show up until the kidneys are already damaged, so it’s important that your doctor monitors your kidney function.
A simple urine test can reveal traces of protein that can signal the onset of kidney disease. Another substance used to measure kidney function is creatinine. This is produced by your body’s muscle cells, and high levels of creatinine in the blood are usually a sign of kidney problems.
People living with HIV need to give their hearts a lot of love. HIV itself increases the risk of heart disease, and people with HIV are more likely to smoke or suffer from diabetes and hypertension, which are all risk factors. What’s more, some HIV medicines may cause a build-up of ‘bad’ cholesterol in the blood. This increases the risk of heart disease because cholesterol can clog the arteries around your heart, restricting blood flow to the heart muscle. If you find your cholesterol levels are too high, you can take steps to reduce them, for example by eating more healthily and doing more exercise and talking to a healthcare professional.
HIV medicines have helped people with HIV to live longer lives, however the increased life expectancy resulted in the unmasking of symptoms that develop during late HIV infections, often caused by older treatment regimens. Neuropathy, a type of nerve damage, occurs frequently in people living with HIV and can significantly interfere with their lives.4
Usually it affects the feet and hands on both sides of the body and involves multiple nerves. The nerve damage can cause pain, tingling and numbness, all of which can range from mild discomfort to sharp burning or shooting sensations. Unfortunately, due to the nature of the pain, which is unlike the pain caused by a headache for example, it can be hard to treat. Therefore, it is really important to keep this in mind and flag early symptoms to your doctor.
Having a healthy sex life when you’re HIV positive is not only possible, but can also be safe and enjoyable. Men with HIV who take treatment as prescribed are unlikely to transmit HIV to a sexual partner who is not HIV positive, but this concept of ‘treatment as prevention’ comes with a few conditions. The person with HIV must consistently take combination HIV treatment as prescribed, to ensure they have an undetectable HIV viral load for at least six months, and have no other sexually transmitted infections (STIs). It’s a good idea to get tested for STIs regularly, as some of them can increase the risk of passing on HIV. It’s also important to tell your partner that you are HIV positive, so that you can both make informed choices.
Always remember that HIV treatments don’t protect against other STIs, some of which are incurable and can cause serious complications for people with and without HIV. Condoms are still the best way to protect yourself and your partner from STIs so they should always be an essential part of your travel kit. It’s easy to lose track of all the different condoms out there – to maintain piece of mind make sure to check the expiration date and use thick condoms with an EU safety mark.
For more information about what condoms to use click here.
Having HIV can be stressful which can in turn affect your sex drive or your ability to have sex. There are also some physical aspects of HIV and its treatments that can affect your sexual performance. In men, HIV can prematurely reduce the levels of testosterone, which in turn may lower your sex drive and cause erectile problems.
Erectile problems can also occur as we get older – sometimes as a symptom of cardiovascular disease, so it is always advisable to discuss erectile problems with your healthcare team.
1. Guerri-Fernandez R, et al. HIV infection is strongly associated with hip fracture risk, independently of age, gender, and comorbidities: a population-based cohort study. .J Bone Miner Res. 2013;28(6):1259-63.
2. Parkin D, et al. The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010. British Journal of Cancer. 2011;105, S77 – S81
3. American Cancer Society. Global Cancer Facts & Figures 2nd Edition. Atlanta: American Cancer Society. 2011
4. Ghosh S, et al. Epidemiology of HIV-Related Neuropathy: A Systematic Literature Review. AIDS Research and Human Retroviruses. 2012; 28(1): 36-48.