Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

Blanco, José Ramón; Jarrín, Inmaculada; Vallejo, Manuel Espinel; Berenguer, Juan; Solera, Carmen; Rubio, Rafael; Pulido, Federico; Asensi, Vı́ctor; Amo, Julia del; Moreno, and CoRIS Santiago

doi:10.1089/aid.2011.0377

Cited by 65 publications

(47 citation statements)

References 50 publications

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“…32 Other variables collected include race/ethnicity, gender, risk factor for HIV infection, location of HIV testing (inpatient, outpatient, or Emergency Department), prior visits to the medical center (inpatient admissions, Emergency Department visits, or outpatient clinic visits in 1 and 5 years prior to diagnosis), and co-morbidities including a current or past history of substance abuse and psychiatric illness.…”

Section: Data Sources and Variablesmentioning

confidence: 99%

A Forgotten Population: Older Adults with Newly Diagnosed HIV

Ellman

Sexton

Warshafsky

et al. 2014

AIDS Patient Care and STDs

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Limited data are available regarding adults age ≥50 at initial HIV diagnosis. Improved understanding of this group is critical in designing interventions to facilitate earlier diagnosis and linkage to HIV care. We characterize individuals newly diagnosed with HIV, particularly those ≥50 years old, and examine the relationship between age and late diagnosis defined as concurrent HIV and AIDS diagnoses. This is a retrospective study of individuals newly diagnosed with HIV from 2006-2011 at an academic medical center in New York City. Multivariable logistic regression was performed to evaluate the effect of age, gender, race/ethnicity, risk factor, and prior medical visits on late diagnosis. Adults age ≥50 comprised 21.3% of all newly diagnosed individuals. Among these older adults, 70.0% were diagnosed as inpatients and 68.9% concurrent with AIDS, compared to 41.7% and 38.9% of younger adults, respectively. On adjusted analyses, age ≥50 (OR 3.13, 95% CI 1.63, 5.98) and injection drug use (OR 4.4, 95% CI 1.31, 14.75) were positively associated with late diagnosis, whereas female gender was negatively associated with late diagnosis (OR 0.52, 95% CI 0.28, 0.98). Our data suggest that HIV testing efforts targeting older adults are essential to address the unmet needs of this population, including implementation of HIV screening guidelines in primary care settings.

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Section: Data Sources and Variablesmentioning

confidence: 99%

A Forgotten Population: Older Adults with Newly Diagnosed HIV

Ellman

Sexton

Warshafsky

et al. 2014

AIDS Patient Care and STDs

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“…By 2015, it is expected that more that 50% of the HIV-infected patients in the United States will be ≥50 years [110]. The age of 50 has been considered as a cut-off to discriminate older subjects within HIV-infected patients [111]. The appearance and maintenance of the low-grade inflammation observed in aging is mainly due to the increased OS [109].…”

Section: Hiv and Oxidative Stressmentioning

confidence: 99%

Role of Mitochondria in HIV Infection and Associated Metabolic Disorders: Focus on Nonalcoholic Fatty Liver Disease and Lipodystrophy Syndrome

Pérez-Matute

Pérez‐Martínez

Blanco

et al. 2013

Oxidative Medicine and Cellular Longevity

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Highly active antiretroviral therapy (HAART) has considerably improved the prognosis of HIV-infected patients. However, prolonged use of HAART has been related to long-term adverse events that can compromise patient health such as HIV-associated lipodystrophy syndrome (HALS) and nonalcoholic fatty liver disease (NAFLD). There is consistent evidence for a central role of mitochondrial dysfunction in these pathologies. Nucleotide reverse transcriptase inhibitors (NRTIs) have been described to be mainly responsible for mitochondrial dysfunction in adipose tissue and liver although nonnucleoside transcriptase inhibitors (NNRTIs) or protease inhibitors (PIs) have also showed mitochondrial toxicity, which is a major concern for the selection and the long-term adherence to a particular therapy. Several mechanisms explain these deleterious effects of HAART on mitochondria, and evidence points to other mechanisms beyond the “Pol-γ hypothesis.” HIV infection has also direct effects on mitochondria. In addition to the negative effects described for HIV itself and/or HAART on mitochondria, HIV-infected patients are more prone to develop a premature aging and, therefore, to present an increased oxidative state that could lead to the development of these metabolic disturbances observed in HIV-infected patients.

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“…Кроме того, иммунологический ответ нередко менее выражен у пожилых пациентов. Показано, что больные старше 50 лет имеют худший иммунологический ответ на АРВТ и низкую выживаемость [10]. Возможно, это связано в первую очередь с дистрофическими изменениями тимуса [11].…”

Section: Discussionunclassified