Survival of Elderly Patients with Transfusion‐Related Acquired Immunodeficiency Syndrome

Sutin, David G.; Rose, David N.; Mulvihill, Michael; Taylor, Brian M.

doi:10.1111/j.1532-5415.1993.tb06694.x

Cited by 27 publications

(6 citation statements)

References 15 publications

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“…In the pre-HAART era, several studies demonstrated that, after HIV seroconversion, patients aged 150 years tended to have a more rapid progression towards AIDS, and poorer survival after the diagnosis of AIDS was established [17][18][19][20][21][22][23][24][25][26][27]. In the HAART era, subsequent studies also suggested that older patients infected with HIV had a delayed immune recovery [28][29][30].…”

Section: Notementioning

confidence: 99%

Perspective on HIV Infection and Aging: Emerging Research on the Horizon

Mayer

Casau

2005

Clinical Infectious Diseases

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A greater prevalence of human immunodeficiency virus (HIV)-infected individuals aged >50 years is projected. This epidemiologic trend will continue to increase as a result of not only greater survival rates among HIV-infected patients who receive treatment, but also of delayed recognition of older individuals with occult HIV disease. Historically, it was thought that, despite viral responses to highly active antiretroviral therapy (HAART) among older individuals that approximate those of younger individuals, older persons infected with HIV could not mount as vigorous an immune response as do younger HIV-infected individuals. However, recent evidence suggests that older HIV-infected individuals may do just as well, because they may be more compliant with their antiretroviral regimens. Limited data are available on the safety and tolerability of HAART in this population. Emerging evidence suggests that metabolic, neuropsychiatric, and cardiovascular morbidities could be exacerbated by use of antiretrovirals or by HIV infection itself. Additional research is needed to optimize the care of older HIV-infected patients.

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Section: Notementioning

confidence: 99%

Perspective on HIV Infection and Aging: Emerging Research on the Horizon

Mayer

Casau

2005

Clinical Infectious Diseases

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“…Older age has been associated with faster progression of HIV infection and shorter survival time after the diagnosis of AIDS [3][4][5][6][7][8]. Randomized, controlled clinical trials for the evaluation of antiretroviral drugs or therapeutic strategies generally exclude older patients and/or those with concurrent disorders.…”

Section: Introductionmentioning

confidence: 99%

Antiretroviral treatment and age‐related comorbidities in a cohort of older HIV‐infected patients

et al. 2006

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The availability of several therapeutic regimens has transformed HIV infection from a lifethreatening disease into a chronic condition. Older patients (450 years old) with HIV infection constitute a new treatment challenge in terms of the cumulative effects of ageing and antiretroviral therapy (ART). MethodsThe immunovirological effects and metabolic interactions of 48 weeks of ART in older patients followed up in three Infectious Diseases Units in Milan, Italy since 1994 were compared with those in younger controls aged 25-35 years. ResultsThe 159 older patients and 118 controls enrolled in the study were comparable for HIV stage, baseline CD4 cell count and viral load but differed for mode of HIV transmission, comorbid conditions and related chronic treatments. Mean viral load decreased after 48 weeks of treatment by 2.6 log 10 HIV RNA copies/mL and CD4 count increased by 137.5 cells/mL in older patients, and similar values for immunovirological effects were obtained in the young controls. The relative risk (RR) of an abnormal test in older patients was 7.33 [95% confidence interval (CI) 4.36-12.36] for glucose, 1.73 (95% CI 1.45-2.07) for total cholesterol, 1.56 (95% CI 1.22-2.0) for high-density lipoprotein cholesterol, 1.26 (95% CI 1.02-1.56) for triglycerides, 6.48 (95% CI 4.36-9.66) for serum creatinine, and 0.45 (95% CI 0.35-0.58) for ALT. Moderate/severe liver and renal toxicities were recorded in the older patients but not in the controls. The tolerability of ART did not differ between the older patients and the controls. Thirty-nine new cardiovascular, endocrine-metabolic and neuralgic disorders (24.52 per 100 person-years) were diagnosed in the older patients and four (3.39 per 100 person-years) in the controls (Po0.0001). ConclusionsDiseases induced by, or related to, the toxic effects of antiretrovirals interact with age-specific health profiles, raising new questions and challenges. Comparative epidemiological studies, research studies addressing specific questions and surveillance are needed to answer the questions that arise in clinical monitoring.

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“…In persons with hemophilia, the relative risk of developing AIDS after seroconversion is 1.45 for each 10-year increase in age [6]. The duration of survival is also significantly shorter for elderly persons [8][9][10][11], and older patients have poorer outcomes of opportunistic infections than do younger individuals [12,13]. These data suggest that older patients might benefit from treatment more than do younger people.…”

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confidence: 99%

Greater Effect of Highly Active Antiretroviral Therapy on Survival in People Aged ⩾50 Years Compared with Younger People in an Urban Observational Cohort

Perez

Moore

2003

CLIN INFECT DIS

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Although human immunodeficiency virus-infected people aged > or =50 years have a blunted CD4 cell recovery when receiving highly active antiretroviral therapy (HAART), there are few data on mortality. Mortality rates were studied for 253 individuals aged > or =50 years and a younger group of 535 people in a retrospective cohort; for untreated persons in each age group, the proportions surviving at 3 years were 83% and 70% (P<.01), respectively. No significant difference in the survival rate was found between the older (83%) and younger (89%) patients who received HAART (P=.29). The hazard ratio for death in the older untreated group was 2.4 (95% confidence interval [CI], 1.4-3.9) when exposed to HAART. However, compared with older untreated patients, the hazard ratio for death decreased to 0.28 (95% CI, 0.15-0.52) for treated older adults. The effect of HAART substantially improves the survival rate for older individuals and supports the importance of treatment in this group.

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Survival of Elderly Patients with Transfusion‐Related Acquired Immunodeficiency Syndrome

Abstract: Age over 40 years is an independent risk factor for poor survival among transfusion-related AIDS patients. Among the elderly, patients with transfusion-related AIDS have similar survivals to patients with IVDU-related AIDS.

Cited by 27 publications

References 15 publications

Perspective on HIV Infection and Aging: Emerging Research on the Horizon

Perspective on HIV Infection and Aging: Emerging Research on the Horizon

Antiretroviral treatment and age‐related comorbidities in a cohort of older HIV‐infected patients

Greater Effect of Highly Active Antiretroviral Therapy on Survival in People Aged ⩾50 Years Compared with Younger People in an Urban Observational Cohort

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