title: Association of aging and survival in a large HIV-infected cohort on antiretroviral therapy.
abstract: OBJECTIVE
  To examine if there is a significant difference in survival between elderly (>50 years) and nonelderly adult patients receiving combination antiretroviral therapy in Uganda between 2004 and 2010.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Patients 18-49 years of age (nonelderly) and 50 years of age and older enrolled in the AIDS Support Organization Uganda HIV/AIDS national programme were assessed for time to all-cause mortality. We applied a Weibull multivariable regression.
  
  
  RESULTS
  Among the 22 087 patients eligible for analyses, 19 657 (89.0%) were aged between 18 and 49 years and 2430 (11.0%) were aged 50 years or older. These populations differed in terms of the distributions of sex, baseline CD4 cell count and death. The age group 40-44 displayed the lowest crude mortality rate [31.4 deaths per 1000 person-years; 95% confidence interval (CI) 28.1, 34.7) and the age group 60-64 displayed the highest crude mortality rate (58.9 deaths per 1000 person-years; 95% CI 42.2, 75.5). Kaplan-Meier survival estimates indicated that nonelderly patients had better survival than elderly patients (P < 0.001). Adjusted Weibull analysis indicated that elderly age status was importantly associated (adjusted hazard ratio 1.23, 95% CI 1.08-1.42) with mortality, when controlling for sex, baseline CD4 cell count and year of therapy initiation.
  
  
  CONCLUSIONS
  As antiretroviral treatment cohorts mature, the proportion of patients who are elderly will inevitably increase. Elderly patients may require focused clinical care that extends beyond HIV treatment.
authors.affiliation: The AIDS Support Organization Headquarters, Kampala, Uganda.
authors.forename: Celestin
authors.initials: C
authors.lastname: Bakanda
authors.forename: Josephine
authors.initials: J
authors.lastname: Birungi
authors.forename: Robert
authors.initials: R
authors.lastname: Mwesigwa
authors.forename: Nathan
authors.initials: N
authors.lastname: Ford
authors.forename: Curtis L
authors.initials: CL
authors.lastname: Cooper
authors.forename: Christopher
authors.initials: C
authors.lastname: Au-Yeung
authors.forename: Keith
authors.initials: K
authors.lastname: Chan
authors.forename: Jean B
authors.initials: JB
authors.lastname: Nachega
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
authors.forename: Mark
authors.initials: M
authors.lastname: Dybul
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Mills
mesh_terms: D015526:AIDS Dementia Complex / Q000401:mortality* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality* / Q000503:physiopathology; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents