Background: Nationwide, 11% of HIV-infected patients are age 50 or over. Previous studies suggest these older patients have later diagnosis and worse prognosis. Objective: To identify age-related differences in the circumstances of diagnosis and progression of HIV disease. Design: Cross-sectional and longitudinal analyses of responses from a nationally representative sample of HIV-infected patients under care in the United States. A baseline interview was conducted in 1996-1997 and a follow-up survey in 1997-1998. Methods: Comparison of older (>=50 years) and younger participants stratified by race. Multivariate regression models controlled for demographic, therapeutic, and clinical factors. Results: Among persons completing the baseline interview, 286 of 2864 were older than 50 with equal racial distribution between age strata. Older nonwhites more often had HIV discovered in a setting of acute illness (odds ratio (OR) 2.29, 95% confidence interval (CI): 1.56, 3.35) with a lower but not statistically different first CD4 count, after multivariate adjustment. At study entry, older nonwhite subjects were less likely to have an AIDS defining diagnosis (OR 0.46, 95% CI 0.24, 0.89) and reported the fewest symptoms. Follow-up revealed a trend towards lower survival in older nonwhites (mean follow-up time 14 months) and few clinical differences between age groups. Conclusions: Clinical disease appears to be similar between older and younger HIV-infected persons. Older nonwhites are diagnosed more often in the setting of acute illness and with more advanced disease and appear to have a somewhat more rapid progression of disease. Older nonwhite individuals should be targeted for earlier diagnosis of HIV disease.
Learning Objectives: N/A
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.