Department of Medicine, Section of Infectious Diseases, Yale AIDS Program, Yale University School of Medicine, 135 College Street, Suite 323, New Haven, CT, 06510, USA.
Yale AIDS Program, Yale University School of Medicine, New Haven, CT, USA.
BMC Geriatr. 2020 Oct 31;20(1):438. doi: 10.1186/s12877-020-01842-y.
Late diagnosis of human immunodeficiency virus (HIV) is associated with increased morbidity and mortality, and represents a serious public health concern.
A retrospective medical record review was conducted on 188 patients with newly diagnosed HIV at a large academic center's HIV clinic from 1/2010 to 12/2019. Patient demographic data, HIV staging, and response to combination antiretroviral therapy (cART) as measured by HIV viral suppression at 12 weeks (HIV RNA < 50 copies) were collected. Bivariate analyses were applied to compare patients ≥50 years old to those < 50 years old.
Over two-thirds of the older patients with a new diagnosis of HIV presented with a CD4 count < 200, or an AIDS-defining illness. Though not statistically significant, this same group also had a delay to viral suppression with only 59% achieving viral suppression after 12-weeks of cART initiation.
This study suggests that older patients are presenting to care with advanced stages of HIV, and may also have a delay in achieving viral suppression after cART initiation. Future studies should aim to target HIV testing and treatment strategies for this at-risk older adult group.
人类免疫缺陷病毒（HIV）的晚期诊断与发病率和死亡率的增加有关，是一个严重的公共卫生问题。
对 2010 年 1 月至 2019 年 12 月在一家大型学术中心的 HIV 诊所新诊断出 HIV 的 188 例患者进行回顾性病历审查。收集患者的人口统计学数据、HIV 分期以及对联合抗逆转录病毒疗法（cART）的反应（通过 12 周时的 HIV 病毒载量抑制[HIV RNA <50 拷贝]来衡量）。应用双变量分析比较年龄≥50 岁和<50 岁的患者。
超过三分之二新诊断出 HIV 的老年患者的 CD4 计数<200，或患有艾滋病定义性疾病。尽管没有统计学意义，但这同一组患者在开始 cART 后 12 周时也出现病毒抑制延迟，只有 59%的患者达到病毒抑制。
本研究表明，老年患者在就诊时已经处于 HIV 的晚期阶段，并且在开始 cART 后也可能出现病毒抑制延迟。未来的研究应针对这一高危老年人群的 HIV 检测和治疗策略。
