Gordon S M, Thompson S
Emory University School of Medicine, Department of Medicine, Atlanta, Georgia.
J Am Geriatr Soc. 1995 Jan;43(1):7-9. doi: 10.1111/j.1532-5415.1995.tb06234.x.
To describe the epidemiology of human immunodeficiency virus (HIV) infection diagnosed in persons aged 60 years and older at a large urban county hospital.
Retrospective chart review of patients, aged 60 years and older, diagnosed with HIV infection, among 6,493 patients identified with positive EIA-HIV tests performed at Grady Memorial Hospital between January 1, 1985 and July 1, 1992.
A total of 32 HIV-infected elderly patients, including 27 men and five women, with a mean age of 64.8 years (range, 60-83 years) were identified. Among the 27 men, HIV risk factors included: homosexual/bisexual (10 patients); injection drug users (IDU) (5); transfusion-associated (2); heterosexual (2); eight patients had no HIV risk factor identified. Among the five women, only one had an identified risk factor (blood transfusion). HIV testing of 47% (15/32) elderly patients was performed after a diagnosis of an AIDS-defining opportunistic infection. Among 24 elderly patients who presented to a physician with signs or symptoms of HIV infection, testing for HIV was often delayed (median 3.1 months, range: 1-10 months). Eleven patients underwent work-ups to rule out a malignancy, and three patients were initially diagnosed with organic brain syndrome. Ten of the 32 patients (31%) had a history of syphilis, and 90% (19/21) of patients tested were found to be immune to hepatitis B.
The majority of HIV-infected patients 60 years or older acquired their infection through sexual intercourse or IDU. The diagnosis of HIV infection in the elderly was usually not considered by clinicians until late in the course of infection, despite a high prevalence of prior sexually transmitted diseases (STDs). Our data indicate that clinicians who take care of elderly patients should do a complete sexual history and offer sexual education. HIV testing and counseling should be considered for all individuals with a history of recent STDs or reporting behaviors putting them at risk for HIV infection.
描述在一家大型城市县医院诊断出的60岁及以上人群感染人类免疫缺陷病毒（HIV）的流行病学情况。
对1985年1月1日至1992年7月1日期间在格雷迪纪念医院进行的6493例酶免疫法检测HIV呈阳性的患者中，年龄在60岁及以上且被诊断为HIV感染的患者进行回顾性病历审查。
共确定了32例感染HIV的老年患者，包括27名男性和5名女性，平均年龄为64.8岁（范围为60 - 83岁）。在27名男性中，HIV危险因素包括：同性恋/双性恋（10例）；注射吸毒者（5例）；输血相关（2例）；异性恋（2例）；8例患者未发现HIV危险因素。在5名女性中，只有1例有明确的危险因素（输血）。47%（15/32）的老年患者在诊断出艾滋病界定的机会性感染后才进行HIV检测。在24名因HIV感染体征或症状就诊的老年患者中，HIV检测常常延迟（中位数为3.1个月，范围为1 - 10个月）。11例患者接受了排除恶性肿瘤的检查，3例患者最初被诊断为器质性脑综合征。32例患者中有10例（31%）有梅毒病史，90%（19/21）接受检测的患者对乙肝免疫。
大多数60岁及以上感染HIV的患者是通过性行为或注射吸毒感染的。尽管先前性传播疾病（STD）的患病率很高，但临床医生通常直到感染后期才考虑对老年人进行HIV感染诊断。我们的数据表明，照顾老年患者的临床医生应进行完整的性病史询问并提供性教育。对于所有有近期STD病史或报告有感染HIV风险行为的个体，都应考虑进行HIV检测和咨询。
