– It’s been 30 years since Greg Sanchez’s HIV was diagnosed, and he keeps his more than two dozen bottles of pills and other medications on his wooden nightstand so he can get to them easily.

But he takes only a single pill for HIV, the human immunodeficiency virus that causes AIDS. The rest of his prescriptions are to treat the ailments and conditions that he says are a result of aging with the virus, along with years of taking the sometimes toxic medications to treat it.

At 50, Sanchez has coronary artery disease, fibromyalgia and arthritis, among other illnesses. He suffers chronic pain in his knees and back and walks with a cane because of vertigo and neuropathy. Advancing bone disease has left him in need of hip surgery.

“I’m grateful to still be alive, but my body is probably about 20 years older than I actually am,” he said. “I’m going to the doctors constantly. Sometimes it’s hard to put my finger on if it is the HIV, or if it’s just getting older.

“Sometimes I feel like an old man.”

In the decades since HIV emerged, it has evolved from a diagnosis with an almost certain death sentence to a chronic illness. Now, those who receive diagnoses while relatively young have lived into middle age and even longer with the disease. In some cases, they have lived with HIV for more than a quarter-century.

As these long-term survivors get older, though, some are finding their bodies wearing out, their internal organs battered by potent and sometimes toxic medications, the devastatingly permanent conditions that come with aging leaving their mark a lot faster.

One study at the University of California, Los Angeles, suggests that HIV-positive blood samples showed signs of aging 14 years faster than the blood of healthy individuals. But researchers have more work to do to determine why, said Tammy Rickabaugh, an assistant researcher with the project. “We definitely see from studies that HIV-infected people tend to have clinical conditions earlier: frailty, diabetes, high blood pressure,” she said. “What’s difficult to tease out is how much of that is because of the virus and how much of that is from drug treatment.”