A new medical literature review has identified a roster of aging-related health conditions associated with HIV. The researchers reviewed 20 studies that covered HIV’s potential link to 55 health outcomes.

They found that four aging-related outcomes had a statistically significant association with HIV, meaning the connection is unlikely to have been driven by chance. These include shortness of breath, chronic obstructive pulmonary disease (COPD, a chronic inflammatory lung disease that obstructs airflow to the lungs), anemia and bone fractures.

Two additional aging-related conditions had a highly statistically significant association with HIV: cough and ischemic heart disease (a narrowing of the arteries that supply the heart).

“With the increase in life expectancy of those living with HIV, there is an increase in older adults living with the condition,” says the study’s lead author, Lee Smith, PhD, of the Cambridge Centre for Sport and Exercise Sciences in England. “In this regard, lifestyle issues are becoming more and more important in this population as they seem to be disproportionately affected by noncommunicable chronic diseases.”