HIV-1 infection in subjects older than 70: a multicenter cross-sectional assessment in Catalonia, Spain.
We designed a multicenter cross-sectional study to describe the epidemiological characteristics of the HIV-1-infected population aged 70 years or more in our setting. 179 individuals from eight university hospitals in Barcelona, Spain, were included, representing 1.5% of HIV-1 infected subjects followed during 2008. Most subjects were male (76%) and had acquired HIV infection through sexual intercourse (87%); 69% had been diagnosed with HIV-1 after their sixties. The CD4 cell counts at HIV-1 diagnosis were < 200 cells/mm(3) in 52% of individuals, whereas this was only seen in 34% of subjects from a published cohort including younger HIV- infected adults from the same setting [1]. Most of our patients were on HAART, had undetectable HIV-1 viremia and the most recent median CD4 cell counts were >or= 350 cells/mm(3). 154 subjects had at least one comorbid condition, including dyslipidemia (54%), hypertension (36%), hyperglycemia or diabetes (30%), cardiovascular disease (23%), chronic renal failure (18%), history of neoplasia (17%) and cognitive impairment (11%). Lipodystrophy was reported in 58% of individuals. Rates of hypercholesterolemia, diabetes and cancer were higher than those reported in unselected local population (28%, 17% and 7%, respectively). The study participants were taking an average of 2.97 drugs (range 1-10) other than antiretrovirals. In conclusion, the elder population infected with HIV-1 is likely being diagnosed late and at lower CD4+ counts and is frequently affected by comorbidities and co-medication. Based on our findings, we suggest some recommendations regarding the management of this growing population.
Mothe
Beatriz
B
Lluita contra la Sida' Foundation, Hospital Universitari Germans Trias i Pujol, Catalonia, Spain.
Perez
Iñaki
I
Domingo
Pere
P
Podzamczer
Daniel
D
Ribera
Esteban
E
Curran
Adrian
A
Viladés
Consuelo
C
Vidal
Francesc
F
Dalmau
David
D
Pedrol
Enrique
E
Negredo
Eugenia
E
Moltó
José
J
Paredes
Roger
R
Perez-Alvarez
Núria
N
Gatell
Jose Maria
JM
Clotet
Bonaventura
B
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D044882:Glucose Metabolism Disorders / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015497:HIV-1; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D008297:Male; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D014652:Vascular Diseases / Q000453:epidemiology