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575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care
BACKGROUND: 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 US HIV population is over 50 years o...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255058/ http://dx.doi.org/10.1093/ofid/ofy210.583 |
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author | Rizk, Christina Taylor, Bennie Yasin, Faiza Barakat, Lydia |
author_facet | Rizk, Christina Taylor, Bennie Yasin, Faiza Barakat, Lydia |
author_sort | Rizk, Christina |
collection | PubMed |
description | BACKGROUND: 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 US 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. METHODS: A retrospective medical record review of all newly diagnosed HIV-infected patients was conducted at a single academic center HIV ambulatory clinic from January 1, 2010 to December 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 two groups of HIV-infected patients: younger group (age <50 years) and older group (age 50 years and older). RESULTS: From 2010 to 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 with the younger group [19 (61.3%) vs. 29 (29.3%), respectively]. Of those eight (42%) were older than 60 years. Compared with 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 an 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 groups were on an integrase inhibitor ART-based regimen. CONCLUSION: 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 with younger patient group. These findings are alarming and require emphasize on early HIV diagnosis. More data are required to understand the immune response to cART. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6255058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62550582018-11-28 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care Rizk, Christina Taylor, Bennie Yasin, Faiza Barakat, Lydia Open Forum Infect Dis Abstracts BACKGROUND: 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 US 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. METHODS: A retrospective medical record review of all newly diagnosed HIV-infected patients was conducted at a single academic center HIV ambulatory clinic from January 1, 2010 to December 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 two groups of HIV-infected patients: younger group (age <50 years) and older group (age 50 years and older). RESULTS: From 2010 to 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 with the younger group [19 (61.3%) vs. 29 (29.3%), respectively]. Of those eight (42%) were older than 60 years. Compared with 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 an 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 groups were on an integrase inhibitor ART-based regimen. CONCLUSION: 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 with younger patient group. These findings are alarming and require emphasize on early HIV diagnosis. More data are required to understand the immune response to cART. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6255058/ http://dx.doi.org/10.1093/ofid/ofy210.583 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Abstracts Rizk, Christina Taylor, Bennie Yasin, Faiza Barakat, Lydia 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title | 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title_full | 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title_fullStr | 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title_full_unstemmed | 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title_short | 575. Older HIV-Infected Adults Are Twice More Likely to Present Late to Care |
title_sort | 575. older hiv-infected adults are twice more likely to present late to care |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255058/ http://dx.doi.org/10.1093/ofid/ofy210.583 |
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