HIV among the elderly with special reference to mode of presentation at a tertiary care hospital in Kolkata, India

Abstract

Epidemiological data of HIV affected individuals of aged 50 years and above in India are lacking for various reasons. Diagnosing HIV infection among the elderly is challenging as chronic HIV/AIDS can mimic those typically associated with aging in parallel to the myth that elderly individuals lead asexual lives. In this study, low-literate, poor, urban men were the major group. The most common presentation at diagnosis was frailty or unexpected weight loss and neurocognitive impairment, whereas the incidence of TB was much less. Policy makers and social workers should be aware of this descriptive analysis in order to address the emerging issue of HIV among geriatrics and to create a broader awareness programme and more liberal HIV testing among this group. This study also highlights the need for a larger population based study involving elderly HIV infected persons in India.

Frailty in People Aging With Human Immunodeficiency Virus (HIV) Infection

“…For instance, analyses of the Multicenter AIDS Cohort Study (MACS) used a frailty scale based on 4 self-reported deficits: weight loss, exhaustion, impaired physical activity, and difficulty walking [29]. One study used a single measure of unexpected weight loss to define frailty [40]. No published studies of frailty in people with HIV have used the cumulative deficit/frailty index approach, or scales based on clinical judgment.…”

Clinicoepidemiological Profile of Elderly PLHIV Attending a Tertiary Care Center in South India

“…In the Kolkata study, majority of PLHIV belonged to stage 4. 12 In our study, the mean CD4 count was 308 + 224.8 cells/mm 3 . The mean CD4 count in the Greek study 9 was 303.86 + 236.22 cells/mm 3 .…”

“…Our findings are similar to the Kolkata and the Greek study. 12,17 In a study done in China, majority of elderly PLHIV were females. 25 Majority of elderly PLHIV in our study belonged to stage 1.…”

“…Records of elderly PLHIV patients aged 50 years newly diagnosed and initiated on treatment in our institution from February 2009 to July 2014 (5 years 6 months) were considered for study. 12,15 Those patients with CD4 count <200 cell/mL were classified as late presenters to care. 16 After obtaining the approval from institutional ethics committee, permission was obtained from the medical superintendent of the hospital to access the medical records from the medical records department.…”

“…11 Comorbid illnesses may get aggravated because of the use of cART. 12 Elderly PLHIV exhibit increased susceptibility to the side effects of medications. 13 There is hardly any published literature describing the sociodemographic and clinical characteristics of elderly PLHIV in our country.…”