Increasing age is associated with faster progression to neoplasms but not opportunistic infections in HIV-infected homosexual men.
OBJECTIVE
To characterize the associations of age and progression rates to AIDS-defining neoplasms and opportunistic infections (OI) in HIV-infected homosexual men.


METHODS
Data from 407 homosexual men with documented dates of HIV seroconversion participating in cohort studies from four geographic locations were merged. Kaplan-Meier and Cox proportional hazards analyses were conducted with respect to the association of age with time from seroconversion to the first AIDS-defining neoplasm and OI.


RESULTS
Among the 407 participants, 139 (34%) were diagnosed with AIDS; 45 (11%) with neoplasms and 90 (22%) with OI. Older age at seroconversion was significantly associated with faster progression to neoplasms, but not to OI. For each 10-year increase in age the risk for neoplasms increased 1.65-fold [95% confidence interval (CI), 1.12-2.43], after adjustment for clinical treatments. For OI this risk estimate was 0.98 (95% CI, 0.72-1.34).


CONCLUSIONS
Increasing age is associated with faster progression to AIDS-defining neoplasms, but not with progression to OI. This has not been previously reported and may explain conflicting results in other studies among homosexual men that considered AIDS as a single entity. Our findings suggest that age and AIDS manifestations should be considered, particularly in the context of natural history studies, clinical trials and mathematical modelling.
Veugelers
P J
PJ
Municipal Health Service, Department of Public Health, Amsterdam, The Netherlands.
Strathdee
S A
SA
Tindall
B
B
Page
K A
KA
Moss
A R
AR
Schechter
M T
MT
Montaner
J S
JS
van Griensven
G J
GJ
D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D000367:Age Factors; D001315:Australia; D001955:British Columbia; D015331:Cohort Studies; D006679:HIV Seropositivity / Q000150:complications* / Q000503:physiopathology; D018451:Homosexuality, Male; D006801:Humans; D015994:Incidence; D008223:Lymphoma / Q000150:complications / Q000453:epidemiology*; D008297:Male; D009426:Netherlands; D011336:Probability; D016016:Proportional Hazards Models; D012307:Risk Factors; D012495:San Francisco; D012514:Sarcoma, Kaposi / Q000453:epidemiology*