Divisions of Virology and ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India.
Divisions of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India.
AIDS Res Hum Retroviruses. 2020 Jun;36(6):475-489. doi: 10.1089/AID.2019.0098. Epub 2020 Mar 9.
Elderly people living with HIV are increasing. At present in the United States, nearly half of newly diagnosed HIV-infected people are aged >50 years. Diagnosis and treatment of HIV-infected elderly patients tends to be delayed by several health care factors as several life-threatening diseases are common in elderly people. This study aimed to find the pooled HIV prevalence in elderly population and the present situation of continuum care for the elderly HIV patients through systematic review and meta-analysis. All previously published articles from 2000 to 2018 are retrieved using MEDLINE, PUBMED, Cochrane Library, EMBASE, and Google Scholar. DerSimonian and Laird Random Effects model are used to critically appraise articles. STATA 13.0 is used to perform the meta-analysis and quantum-geographic information system (Q-GIS) is used to prepare desired map. statistics has been used to test heterogeneity and publication biases. Results have been presented using forest plots. A total of 28 studies are included in this meta-analysis. Present analysis revealed pooled prevalence of HIV in elderly population as 15.79% with a lower rate of viral suppression as 11.524% (95% confidence interval, CI: 11.199-11.855), where a moderate number 38.643% (95% CI: 38.289-38.997) of elderly patients received antiretroviral therapy (ART) globally. The ART retention rate was 12.769% (95% CI: 12.540-13.001) with 6.15% (95% CI: 6.089-6.212) mortality. Despite successful administration of ART in developing part of the world that have relatively higher retention rates among HIV-infected elderly patients only a small percentage are virally suppressed, largely due to elderly drugs interact with ART and several comorbidities reduce the life span of the elderly people.
老年艾滋病毒感染者人数不断增加。目前，在美国，近一半新诊断出的艾滋病毒感染者年龄在>50 岁以上。由于老年人常患有多种危及生命的疾病，因此艾滋病毒感染者老年患者的诊断和治疗往往会因多种医疗保健因素而延迟。本研究旨在通过系统评价和荟萃分析，找到老年人群中艾滋病毒的总体流行率，以及老年艾滋病毒患者连续护理的现状。使用 MEDLINE、PUBMED、Cochrane 图书馆、EMBASE 和 Google Scholar 检索了 2000 年至 2018 年期间发表的所有文章。使用 DerSimonian 和 Laird 随机效应模型对文章进行批判性评价。使用 STATA 13.0 进行荟萃分析，使用量子地理信息系统（Q-GIS）制作所需地图。使用统计学检验异质性和发表偏倚。结果以森林图呈现。本荟萃分析共纳入 28 项研究。目前的分析显示，老年人群中艾滋病毒的总体流行率为 15.79%，病毒抑制率较低，为 11.524%（95%置信区间，CI：11.199-11.855），全球有中度比例 38.643%（95% CI：38.289-38.997）的老年患者接受抗逆转录病毒治疗（ART）。ART 保留率为 12.769%（95% CI：12.540-13.001），死亡率为 6.15%（95% CI：6.089-6.212）。尽管在发展中国家成功实施了 ART，这些国家的艾滋病毒老年感染者的保留率相对较高，但只有一小部分患者的病毒得到抑制，这主要是因为老年人的药物与 ART 相互作用，以及多种合并症降低了老年人的寿命。
