There are 36.7 million persons living with HIV globally and 1.1 million in the United States with additional ~45,000 new diagnosis annually. One in six newly diagnosed HIV infected persons is older than 50 years of age. It is estimated that 45% of the U.S. HIV population is over 50 years old and more than 10% are older than 60 years. HIV is more likely to be diagnosed at an advanced stage in older adults. Therefore there is a need to better understand the characteristics, staging of the disease, and response to treatment in older HIV-infected adults, in order to provide an effective treatment and prevention approach.
A retrospective medical record review of all newly diagnosed HIV-infected patients was conducted at a single academic center HIV ambulatory clinic from 1/1/2010 to 12/31/2015. Patients demographics, age group, HIV staging, and response to antiretroviral treatment (ART) measured by HIV viral suppression at 12 weeks (HIV RNA <50 copies), and change in CD4 count were collected. Bivariate analysis was conducted comparing 2 groups of HIV-infected patients: younger group (age less than 50 years) and older group (age 50 years and older).
From 2010-2015, 130 newly diagnosed HIV patients were enrolled in the clinic. Thirty one (23.8%) were 50 years or older and of those 12 (38.7%) were 60 years and older. Older patients group were more likely to have AIDS defining illness at the time of diagnosis, compared to the younger group [19 (61.3%) vs. 29 (29.3%) respectively]. Of those 8 (42%) were older than 60 years. Compared to the younger group, the majority of the HIV-infected patients in the older group who were on ART (61.5%) did not achieve HIV viral suppression at 12 weeks. However both groups accomplished immune reconstitution with a increase in CD4 cell count in older and younger groups (mean CD4 count =132 and 200 cell/dl respectively). More than 80% of patients in both group were on an Integrase Inhibitor ART based regimen.
HIV-infected patients 50 years and older are more likely to present late to care, and to have a delay in HIV viral suppression compared to younger patient group. These findings are alarming and require emphasize on early HIV diagnosis. More data is required to understand the immune response to cART.
F. Yasin, None
L. Barakat, None
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