HIV-1 infected patients older than 50 years. PISCIS cohort study

Navarro, Gemma; Nogueras, María Mercedes; Segura, Ferrán; Casabona, Jordi; Miró, Josep M.; Murillas, Javier; Tural, Cristina; Ferrer, Elena; Jaén, Ángeles; Force, Lluís; Vilaró, Josep; García, Felipe; Masabeu, Àngels; Altés, Jordi; Esteve, Anna; Sued, Omar; Riera, Melchor; Clotet, Bonaventura; Podzamczer, Daniel; Gatell, Josep M.

doi:10.1016/j.jinf.2008.05.003

Cited by 34 publications

(35 citation statements)

References 29 publications

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“…47 The difference may be explained by the more recent initiation of our cohort, which included patients who started therapy after 2004. Mortality is higher among older patients, 16,18,19,30,46,48,49 which has also been observed in patients between 50 and 59 years in our study. This association is not seen in those aged more than 60 years probably due to the small sample size of this group.…”

Section: Discussionsupporting

confidence: 86%

“…Many authors have found no differences in virological control according to age, 7,10,12,[27][28][29][30][31][32]40 and, moreover, some have found a better virological response in older patients. 5,8,9,[15][16][17][18][19] In our case the virological response was similar across all age groups but improved significantly in patients over 60 years. The best virological control in elderly patients has been associated with better adherence to antiretroviral therapy (ART), 18,28,[41][42][43] despite the fact that many of them take other treatments (e.g., antihypertensives, antidiabetics).…”

Section: Discussionsupporting

confidence: 61%

“…However, this has not been observed by other authors. 16,18,19,[27][28][29][30][31][32][33] Perhaps the higher prevalence of delayed HIV described in older patients may contribute to their poorer immune response. 30,32,[34][35][36][37][38] In this sense, we found a late diagnosis of HIV infection in 53.3% of the patients > 50 years vs. 21.5% in those < 30 years ( p < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…4 Based on this arbitrary age cut-off it is generally accepted that HIV-infected patients who start HAART after this age will have a poorer immunological response [5][6][7][8][9][10][11][12][13][14][15] and a better virological response. 5,8,9,[15][16][17][18][19] compared with younger patients. Other studies have found mixed results.…”

Section: Introductionmentioning

confidence: 96%

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Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

Blanco

Jarrín

Vallejo

et al. 2012

AIDS Research and Human Retroviruses

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The age of 50 has been considered as a cut-off to discriminate older subjects within HIV-infected people according to the Centers for Disease Control and Prevention (CDC). However, the International AIDS Society (IAS) mentions 60 years of age and the Department of Health and Human Services (DHHS) makes no consideration. We aimed to establish an age cut-off that could differentiate response to highly active antiretroviral therapy (HAART) and, therefore, help to define advanced age in HIV-infected patients. CoRIS is an open, prospective, multicenter cohort of HIV adults naive to HAART at entry ( January 2004 to October 2009). Survival, immunological response (IR) (CD4 increase of more than 100 cell/ml), and virological response (VR) (HIV RNA less than 50 copies/ml) were compared among 5-year age intervals at start of HAART using Cox proportional hazards models, stratified by hospital and adjusted for potential confounders. Among 5514 patients, 2726 began HAART. During follow-up, 2164 (79.4%) patients experienced an IR, 1686 (61.8%) a VR, and 54 (1.9%) died. Compared with patients aged < 25 years at start of HAART, those aged 50-54, 55-59, 60-64, 65-59, and 70 or older were 32% (aHR: 0.68, 95% CI: 0.52-0.87), 29% (aHR: 0.71, 95% CI: 0.53-0.96), 34% (aHR: 0.66, 95% CI: 0.46-0.95), 39% (aHR: 0.61, 95% CI: 0.37-1.00), and 43% (aHR: 0.57, 95% CI: 0.31-1.04) less likely to experience an IR. The VR was similar across all age groups. Finally, patients aged 50-59 showed a 3-fold increase (aHR: 3.58; 95% CI: 1.07-11.99) in their risk of death compared to those aged < 30 years. In HIV infection, patients aged ‡ 50 years have a poorer immunological response to HAART and a poorer survival. This age could be used to define medically advanced age in HIV-infected people.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

Blanco

Jarrín

Vallejo

et al. 2012

AIDS Research and Human Retroviruses

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“…[4][5][6][7][8][9] Studies in developing countries emphasize the social and economic impact of HIV infection -mainly its effect on older grandparents in their role as caretakers of children orphaned as a result of parental HIV infection -and have ignored the prevalence of HIV infection in older people and its impact on their lives. 10,11 As more people in sub-Saharan Africa have begun taking antiretroviral treatment, mortality rates have dropped 12,13 and HIV+ individuals are surviving longer.…”

Section: Introductionmentioning

confidence: 99%

HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data

Negin

Cumming

2010

Bull. World Health Organ.

202

178

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Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

Abara

Adekeye

et al. 2016

AIDS Behav

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Optimal adherence to combination antiretroviral therapy is essential to the health of older people living with HIV (PLWH), however, the literature on adherence and aging is limited. Using Medicaid data from 29 states (N = 5177), we explored correlates of optimal adherence among older PLWH. The prevalence of optimal adherence was low (32 %) in this study. Males were more adherent than females (APR = 1.11, 95 % CI 1.02–1.21, P = 0.0127); persons with three or more co-morbidities (APR = 0.67, 95 % CI 0.60–0.74, P < 0.001), two co-morbidities (APR = 0.86, 95 % CI 0.75–0.98, P = 0.0319) and one co-morbidity (APR = 0.82, 95 % CI 0.73–0.92, P = 0.0008) were less adherent than those without any co-morbidity; and residents of rural areas (APR = 0.90, 95 % CI 0.63–0.98, P = 0.0385) and small metropolitan areas (APR = 0.82, 95 % CI 0.72–0.94, P = 0.0032) were less adherent than residents of large metropolitan areas. There were no racial differences in optimal adherence. Targeted interventions that provide adherence support, case management, and peer navigation services may be of benefit in achieving optimal adherence in this population.

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HIV-1 infected patients older than 50 years. PISCIS cohort study

Cited by 34 publications

References 29 publications

Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

HIV infection in older adults in sub-Saharan Africa: extrapolating prevalence from existing data

Correlates of Combination Antiretroviral Adherence Among Recently Diagnosed Older HIV-Infected Adults Between 50 and 64 years

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