Aging with HIV: an overview of an urban cohort in Rio de Janeiro (Brazil) across decades of life

Abstract

The introduction of highly active antiretroviral therapy during the 1990s was crucial to the decline in the rates of morbidity and death related to the acquired immunodeficiency syndrome (AIDS) and turned human immunodeficiency virus (HIV) infection into a chronic condition. Consequently, the HIV/AIDS population is becoming older. The aim of this study was to describe the immunological, clinical and comorbidity profile of an urban cohort of patients with HIV/AIDS followed up at Instituto de Pesquisa Clinica Evandro Chagas, Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. Retrospective data from 2307 patients during January 1st, 2008 and December 31st, 2008 were collected. For continuous variables, Cuzick's non-parametric test was used. For categorical variables, the Cochran-Armitage non-parametric test for tendency was used. For all tests, the threshold for statistical significance was set at 5%. In 2008, 1023 (44.3%), 823 (35.7%), 352 (15.3%) and 109 (4.7%) were aged 18-39, 40-49, 50-59 and ≥60 years-old, respectively. Older and elderly patients (≥40 years) were more likely to have viral suppression than younger patients (18-39 years) (p<0.001). No significant difference in the latest CD4(+) T lymphocyte count in the different age strata was observed, although elderly patients (≥ 50 years) had lower CD4(+) T lymphocyte nadir (p<0.02). The number of comorbidities increased with age and the same pattern was observed for the majority of the comorbidities, including diabetes mellitus, dyslipidemia, hypertension, cardiovascular diseases, erectile dysfunction, HCV, renal dysfunction and also for non-AIDS-related cancers (p<0.001). With the survival increase associated to successful antiretroviral therapy and with the increasing new infections among elderly group, the burden associated to the diagnosis and treatment of the non-AIDS related HIV comorbidities will grow. Longitudinal studies on the impact of aging on the HIV/AIDS population are still necessary, especially in resource-limited countries.

Trends of Immuno-virological Response Among HIV-Infected Patients Receiving Highly Active Anti-retroviral Therapy at Hawassa, Southern Ethiopia

“…In similar with this finding, a study from Brazil reported that changes in CD4+ counts after HAART initiation were not significantly different in patients ≥ 50 years compared to younger patients [16]. However in contrast to present study a cohort study from 9 African countries, also reports the median increase in CD4+ count was significantly higher at 6 and 12 months after receiving ART in patients younger than 50 years; P < 0.001 for both phases [17].…”

Systemic Arterial Hypertension in people living with HIV/AIDS: integrative review

“…Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

“…The characterization of the 17 articles showed the year of publication varied between 2001 and 2016, with six articles published in Brazil (10)(11)(12)(13)(14)(15) , five in the United States (16)(17)(18)(19)(20) , four in European countries (21)(22)(23)(24) , one article in Cameroon (25) and one in Chile (26) . Regarding the evidence levels, the following distribution was observed: four on level IV (10,16,20,23) ; three on level V (21)(22)24) ; and ten on level VI (11)(12)(13)(14)(15)(16)(17)(18)(19)(25)(26) .…”

“…Aging with HIV: an overview of an urban cohort in Rio de Janeiro (Brazil) across decades of life (14) Brazil 2013…”

Perfil Metabólico De Portadores Do Hiv - Hospital De Clínicas De Curitiba

“…A TARV também está associada a fatores de risco cardiovascular como dislipidemia, resistência insulínica e diabetes mellitus 9 . Além disso, como a TARV fez da infecção pelo HIV uma condição crônica, é importante considerar as comorbidades relacionadas ao avanço da idade que contribuem para o aumento do risco cardiovascular de portadores do vírus 10 . Com relação às mudanças do perfil metabólico, a infecção pelo HIV causa um desequilíbrio no metabolismo dos lipídios, caracterizado por baixos níveis de HDL-c, LDL-c e CT, e altos níveis de TG 1,5,6,11,12 .…”