European cohorts of older HIV adults: POPPY, AGEhIV, GEPPO, COBRA and FUNCFRAIL

Key summary pointsAimThe aim of this paper is to describe ongoing aging HIV cohorts that include older (>50 years) or geriatric (>65 years) people living with HIV and present the key results obtained in those studies.FindingsExisting aging HIV cohorts are pointing out unmet medical needs of OALWH. However, there are no studies designed to detect best ART strategies in this population and various outcomes that go beyond the viro-immunological success, such as frailty, geriatric syndromes, physical function, disability, quality of life and healthy aging are still not routinely part of aging cohorts.MessageThe already present demographic transition affecting PLWH are not paralleled by significant changes in the clinical management. In order to better describe aging trajectories in this population, it is essential to collect and measure immunological biomarkers. Results from aging HIV observational studies can also inspire randomized clinical trials. AimThe recent and rapid demographic changes affecting people living with HIV (PLWH) produced a subset of older adults demanding a prompt response both in clinical practice and research setting. The scientific community had to properly design studies that include older adults living with HIV (OALWH), aged >50years, or geriatric PLWH, aged >65years to explore the interaction between aging and HIV itself, antiretroviral therapy (ART) and non-infectious co-morbidities (NICM). Choosing between these two types ofcohorts may represent a trap, but also a possibility to measure different outcomes and obtain different evidence.The aim of this paper is to describe ongoing aging HIV cohorts that include olderor geriatric PLWHand present the key results obtained in those studies.MethodsSo far, in Europe, there are ongoing cohorts that comprise OALWH or geriatric PLWH: AGEhIV, POPPY, GEPPO, FUNCFRAIL and COBRA. We will summarize crucial findings from each study published up to now, which will be categorized as results related to HIV and ART, NICM and geriatric syndromes.ResultsExisting aging HIV cohorts are pointing out unmet medical needs of OALWH but are still not representative of the entire European HIV aging epidemic. Moreover, there are no studies designed to detect best ART strategies in this population and various outcomes that go beyond the viro-immunological success are still not routinely part of aging cohorts.ConclusionResults from aging cohorts with outcomes that go beyond the undetectability will pave the way to health care providers to encounter unmet needs of OALWH.