Human Immunodeficiency Virus Infection in Elderly Patients
Human Immunodeficiency Virus Infection in Elderly Patients
Background: The proportion of older individuals infected with the human immunodeficiency virus (HIV) is rising.
Methods: We performed a retrospective case-control study of 58 patients more than 60 years old at the time of diagnosis of HIV infection and compared them with 232 controls (matched by CD4+ lymphocyte count). Clinical and demographic data were obtained from the Adult Spectrum of Diseases (ASD) database at the Medical Center of Louisiana.
Results: Patients in the older age group were more likely to be male and African American or Hispanic. The most common risk factor for acquisition of HIV infection among the patients was homosexual contact (53%). Disease staging was similar in both groups as determined by CD4+ lymphocyte counts and history of opportunistic infections. There was no difference in the use of antiretroviral therapy. In a Cox proportional hazard model and regression models, age ≥60 years was associated with shorter survival.
Conclusion: Patients who are older than 60 years at the time of diagnosis of HIV infection have a shorter survival than younger patients.
As newer drugs for the treatment of HIV infection have become available, morbidity and mortality from this infection and resultant opportunistic infections have decreased. As a result, more patients are surviving into older age. Studies have suggested that the time of progression of HIV infection to acquired immunodeficiency syndrome (AIDS) is shorter in older persons. In addition, older persons are more likely than younger ones to die within the same month of diagnosis of such infection. Present data also suggest that there are important epidemiologic differences between older and younger persons with HIV infection. The proportion of persons with AIDS who are more than 50 years old is around 11% in most studies, and those older than 60 have accounted about 3% of all cases. Since the total number of persons with AIDS grew steadily over the past several years, this has translated to a larger number of persons with AIDS who are older than 60. Many previous studies had used 50 years as the age limit to define elderly patients. We used age >60 years as the definition for the elderly. We believe this is one of the largest studies of HIV-infected patients more than 60 years old.
Background: The proportion of older individuals infected with the human immunodeficiency virus (HIV) is rising.
Methods: We performed a retrospective case-control study of 58 patients more than 60 years old at the time of diagnosis of HIV infection and compared them with 232 controls (matched by CD4+ lymphocyte count). Clinical and demographic data were obtained from the Adult Spectrum of Diseases (ASD) database at the Medical Center of Louisiana.
Results: Patients in the older age group were more likely to be male and African American or Hispanic. The most common risk factor for acquisition of HIV infection among the patients was homosexual contact (53%). Disease staging was similar in both groups as determined by CD4+ lymphocyte counts and history of opportunistic infections. There was no difference in the use of antiretroviral therapy. In a Cox proportional hazard model and regression models, age ≥60 years was associated with shorter survival.
Conclusion: Patients who are older than 60 years at the time of diagnosis of HIV infection have a shorter survival than younger patients.
As newer drugs for the treatment of HIV infection have become available, morbidity and mortality from this infection and resultant opportunistic infections have decreased. As a result, more patients are surviving into older age. Studies have suggested that the time of progression of HIV infection to acquired immunodeficiency syndrome (AIDS) is shorter in older persons. In addition, older persons are more likely than younger ones to die within the same month of diagnosis of such infection. Present data also suggest that there are important epidemiologic differences between older and younger persons with HIV infection. The proportion of persons with AIDS who are more than 50 years old is around 11% in most studies, and those older than 60 have accounted about 3% of all cases. Since the total number of persons with AIDS grew steadily over the past several years, this has translated to a larger number of persons with AIDS who are older than 60. Many previous studies had used 50 years as the age limit to define elderly patients. We used age >60 years as the definition for the elderly. We believe this is one of the largest studies of HIV-infected patients more than 60 years old.
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