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

Aim: The 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 > 50 years, or geriatric PLWH, aged > 65 years to explore the interaction between aging and HIV itself, antiretroviral therapy (ART) and non-infectious co-morbidities (NICM). Choosing between these two types of cohorts 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 older or geriatric PLWH and present the key results obtained in those studies. Methods: So 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. Results: Existing 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. Conclusion: Results from aging cohorts with outcomes that go beyond the undetectability will pave the way to health care providers to encounter unmet needs of OALWH.