Consequências da infecção pelo vírus da imunodeficiência humana na terceira idade: uma revisão de literatura

Abstract

In Brazil, the incidence rate of cases of Acquired Immunodeficiency Syndrome (AIDS) in people over 60 was 10.0 / 100,000 inhabitants in 2000 to 14.5 / 100 000 inhabitants in 2010. This increase appears to be related to an active sexual life among the elderly. There is a stigma in society that the elderly maintain a sexually inactive life, and therefore they are not vulnerable to HIV infection. However, the literature shows that with the advent of new therapeutic methods, this reality is outdated. In this context, it is worth noting the morphological and functional changes in the immune system, highly responsive at puberty, but in gradual decline during aging, resulting in a higher incidence of infections, autoimmune diseases and cancer in old age. Thus, the aim of this study was to know the aspects of HIV infection in the elderly due to the physiological aging of the immune system in these individuals. This is a literature review work carried out between the months of October 2013 to February 2015. For the literature review were accessed PubMed, SciELO, LILACS, Google Scholar, using the keywords: imunosenescência / immunosenescence , idoso / AIDS, elderly population / AIDS. The study showed that during the aging process there is an impairment of functional activity of dendritic cells, compromising the interaction between B and T lymphocytes, increased production of proinflammatory cytokines (IL-1, IL-6, TNF-α), thymic involution, making older individuals diagnosed with HIV more susceptible to rapid progression of disease. Allied to this, both HIV infection as the immunosenescence are marked by an increased proportion of CD28 - cells, CD57 + cells and CD8 + memory with reduced capacity to produce IL - 2 and increased production of IL - 6. The lack of knowledge about the transmission of sexually transmitted diseases by older people makes them a vulnerable group to those diseases, besides the conditions related to HIV infection can be confused with conditions related to aging, for example, some physical symptoms such as fatigue, lack of breath, chronic pain, weight loss, anorexia, memory impairment, which may hinder the differential diagnosis. We conclude that greater attention should be given by health professionals by stimulating special care in primary care aimed at this elderly people.