Older age does not influence CD4 cell recovery in HIV-1 infected patients receiving highly active antiretroviral therapy.
BACKGROUND
Diagnosis of HIV infection is recently occurring with increasing frequency in middle-aged and in older individuals. As HAART became available, a minimal beneficial effect on immunological outcome in older in respect of younger subjects has been reported. In fact, both the intensity and the rapidity of the immunological response appeared to be reduced in elderly subjects. On the contrary, only few reports have indicated a similar immunological outcome both in older and younger HIV-positive subjects. Interestingly, older age did not seem to significantly affect the long-term virological outcome of HAART treated subjects.


METHODS
To characterise epidemiological and clinical features of older HIV+ subjects, a prospective case-control study was performed: 120 subjects >/= 50 and 476 between 20 and 35 years were initially compared. Subsequently, to better define the impact of HAART on their viro-immunological response, 81 older were compared with 162 younger subjects.


RESULTS
At baseline cases presented significantly lower TCD4+ cell number and were more frequently affected by comorbid conditions. Under HAART a statistically significant increase in TCD4+ cell number was observed in cases and controls. At multivariate analysis, there was no statistically significant difference between cases and controls regarding viro-immunological response.


CONCLUSIONS
Although older subjects present a more severe HIV infection, they can achieve, under HAART, the same viro-immunological success as the younger individuals.
Tumbarello
Mario
M
Department of Infectious Diseases, Catholic University, Rome, Italy. tumbarello@rm.unicatt.it
Rabagliati
Ricardo
R
de Gaetano Donati
Katleen
K
Bertagnolio
Silvia
S
Montuori
Eva
E
Tamburrini
Enrica
E
Tacconelli
Evelina
E
Cauda
Roberto
R
D000328:Adult; D000367:Age Factors; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012720:Severity of Illness Index