1(st) Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54006, Thessaloniki, Greece.
Int J Infect Dis. 2013 Oct;17(10):e883-91. doi: 10.1016/j.ijid.2013.02.023. Epub 2013 Apr 30.
HIV prevalence among older people is on the increase. The aim of this study was to evaluate the epidemiological and clinical features at diagnosis and survival of older patients.
This was a retrospective analysis of the data of 558 newly diagnosed antiretroviral-naïve patients between January 1998 and December 2008. Patients were divided into two groups according to their age at diagnosis: ≥50 years (n=103) and 18-49 years (n=455).
The most common risk factor for older patients was heterosexual contact (p<0.013). Older patients were more likely to suffer from hypertension (33.0% vs. 5.1%, p<0.0005), cardiovascular disease (20.4% vs. 2.9%, p<0.0005), neurological disorders (11.7% vs. 5.5%, p=0.02), renal dysfunction (12.6% vs. 5.3%, p=0.01), and infections (66.0% vs. 49.7%, p=0.003) than their younger counterparts, and to have more hospital admissions during follow-up (47.5% vs. 19.6%, p<0.0005). Older patients had a shorter survival time (p<0.0005). A statistically significant increase in CD4+ cell number through time was observed in both groups (p<0.0005). Younger patients reached higher magnitudes of absolute numbers of CD4+ cells during follow-up (p<0.0005) after the initiation of antiretroviral therapy. The total number of patients with clinical AIDS from baseline throughout the study period was also higher in the older age group (35.9% vs. 25.0%).
HIV-infected people aged ≥50 years differ in epidemiological and clinical features to younger HIV-infected people. The issue of increasing prevalence of HIV infection is a matter of concern due to existing comorbidities, which probably lead to higher mortality rates and faster progression to clinical AIDS.
老年人中的 HIV 感染率正在上升。本研究旨在评估新诊断的抗逆转录病毒初治患者的流行病学和临床特征及生存情况。
本研究为回顾性分析，纳入 1998 年 1 月至 2008 年 12 月间新诊断的 558 例抗逆转录病毒初治患者，根据诊断时的年龄将患者分为两组：年龄≥50 岁（n=103）和 18-49 岁（n=455）。
老年患者最常见的感染途径是异性性接触（p<0.013）。与年轻患者相比，老年患者更易患有高血压（33.0% vs. 5.1%，p<0.0005）、心血管疾病（20.4% vs. 2.9%，p<0.0005）、神经系统疾病（11.7% vs. 5.5%，p=0.02）、肾功能不全（12.6% vs. 5.3%，p=0.01）和感染（66.0% vs. 49.7%，p=0.003），且在随访期间住院治疗的次数更多（47.5% vs. 19.6%，p<0.0005）。老年患者的生存时间更短（p<0.0005）。两组患者的 CD4+细胞计数随时间均呈上升趋势（p<0.0005）。与年轻患者相比，老年患者在接受抗逆转录病毒治疗后，随访期间的 CD4+细胞绝对计数更高（p<0.0005）。在整个研究期间，从基线到研究结束时，老年组出现临床艾滋病的患者总数也高于年轻组（35.9% vs. 25.0%）。
与年轻的 HIV 感染者相比，年龄≥50 岁的 HIV 感染者在流行病学和临床特征方面存在差异。由于存在合并症，HIV 感染率不断增加，这可能导致死亡率更高，且更快进展为临床艾滋病，这是一个值得关注的问题。
