1471-2458-13-397_biomed.pdf (545 kB)
Older HIV-infected individuals present late and have a higher mortality: Brighton, UK cohort study
journal contribution
posted on 2023-06-08, 15:29 authored by Collins C Iwuji, Duncan Churchill, Yvonne Gilleece, Helen A Weiss, Martin FisherBACKGROUND Initiating therapy with a low CD4 cell count is associated with a substantially greater risk of disease progression and death than earlier initiation. We examined factors associated with late presentation of HIV using the new European consensus definition (CD4 cell count <350 cells/mm3) and mortality. METHODS Patients newly diagnosed with HIV infection at a UK clinic were recruited from January 1996 to May 2010. Factors associated with late presentation were assessed using logistic regression. Factors associated with mortality rates were analysed using Poisson regression. RESULTS Of the 1536 included in the analysis, 86% were male and 10% were aged 50 years and older. Half the cohort (49%) had a CD4 cell count below 350 cells/mm3 at presentation ("late presentation"). The frequency of late presentation was highest in those aged 50 years or older and remained unchanged over time (64.3% in 1996-1998 and 65.4% in 2008-2010). In contrast, among those aged less than 50 years, the proportion with late presentation decreased over time (57.1% in 1996-1998 and 38.5% in 2008-2010). Other factors associated with late presentation were African ethnicity and being a male heterosexual.The mortality rate was 15.47/1000 person-years (pyrs) (95%-CI: 13.00-18.41). When compared with younger adults, older individuals had a higher mortality, after adjusting for confounders (rate ratio (RR)?=?2.87; 95%-CI: 1.88-4.40). CONCLUSIONS Older adults were more likely to present late and had a higher mortality. Initiatives to expand HIV testing in clinical and community setting should not neglect individuals aged over 50.
History
Publication status
- Published
File Version
- Published version
Journal
BMC Public HealthISSN
1471-2458Publisher
BioMed CentralExternal DOI
Volume
13Page range
397Department affiliated with
- BSMS Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2013-08-19First Open Access (FOA) Date
2013-08-19First Compliant Deposit (FCD) Date
2013-08-19Usage metrics
Categories
No categories selectedKeywords
Licence
Exports
RefWorks
BibTeX
Ref. manager
Endnote
DataCite
NLM
DC