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Title: HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)
Authors: N. Han
S. T. Wright
C. C. O'Connor
J. Hoy
S. Ponnampalavanar
M. Grotowski
H. X. Zhao
A. Kamarulzaman
D. Ellis
M. Bloch
T. Franic
S. Agrawal
L. McCann
N. Cunningham
T. Vincent
D. Allen
J. L. Little
D. Smith
C. Gray
D. Baker
R. Vale
D. J. Templeton
C. Dijanosic
E. Jackson
K. McCallum
S. Taylor
D. Cooper
A. Carr
F. Lee
K. Hesse
K. Sinn
R. Norris
R. Finlayson
I. Prone
J. Shakeshaft
K. Brown
C. McGrath
V. McGrath
S. Halligan
L. Wray
P. Read
H. Lu
D. Couldwell
V. Furner
J. Watson
C. Lawrence
B. Mulhall
Matthew Law
K. Petoumenos
H. McManus
C. Bendall
M. Boyd
A. Kulatunga
P. Knibbs
J. Chuah
M. Ngieng
B. Dickson
D. Russell
S. Downing
D. Sowden
J. Broom
K. Taing
C. Johnston
K. McGill
D. Orth
D. Youds
M. Kelly
A. Gibson
H. Magon
W. Donohue
R. Moore
S. Edwards
R. Liddle
P. Locke
N. J. Roth
J. Nicolson
H. Lau
T. Read
J. Silvers
W. Zeng
K. Watson
M. Bryant
S. Price
I. Woolley
M. Giles
T. Korman
J. Williams
D. Nolan
J. Skett
J. Robinson
C. V. Mean
V. Saphonn
K. Vohith
F. J. Zhang
Beijing Ditan Hospital
University of New South Wales (UNSW) Australia
RPA Sexual Health
The University of Sydney
Monash University
University of Malaya Medical Centre
Hunter New England Area Health Service - Clinic 468
General Medical Practice
Holdsworth House General Practice
Holden Street Clinic
Lismore Sexual Health Services
East Sydney Doctors
Blue Mountains Sexual Health and HIV Clinic
Tamworth Sexual Health Service
St. Vincent's Hospital Sydney
Nepean Sexual Health and HIV Clinic
Illawarra Sexual Health
Sydney Sexual Health Centre
Parramatta Sexual Health Clinic , Sexually Transmitted Infections Research Centre
Dubbo Sexual Health Centre
National Association of People Living with HIV/AIDS
National Aboriginal Community Controlled Health Organisation
Royal Darwin Hospital
Gold Coast Health Service District
Cairns Sexual Health Service
Sunshine Coast-Wide Bay Health Service District
Brisbane Sexual Health and HIV Service
Northside Clinic
Prahran Market Clinic
Melbourne Sexual Health Centre
Alfred Hospital
Monash Medical Centre
Royal Perth Hospital
National Center for HIV/AIDS
Queen Elizabeth Hospital Hong Kong
YR Gaitonde Centre for AIDS Research and Education
Institute of Infectious Diseases
Keywords: Medicine
Issue Date: 1-Mar-2015
Citation: HIV Medicine. Vol.16, No.3 (2015), 152-160
Abstract: © 2014 British HIV Association. Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.
ISSN: 14681293
Appears in Collections:Scopus 2011-2015

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