title: Older age at initial presentation to human immunodeficiency virus (HIV) care and treatment at the Communicable Disease Centre (CDC) in Singapore, 2006 to 2011.
abstract: BACKGROUND
  The incidence of newly diagnosed older patients diagnosed with human immunodeficiency virus (HIV) has increased worldwide in recent years. In this study, we compared the demographics and clinical presentation of younger and older patients in our HIV sentinel cohort.
  
  
  METHODS
  Among all HIV patients presenting to the Communicable Disease Centre (CDC), Singapore from 2006 to 2011, 793 were randomly included in our cohort, representing about 50% of the patients seen during that period. We collected demographic, clinical, laboratory, and outcome data from patient records to compare younger (<50 years old) and older (≥50 years old) HIV patients.
  
  
  RESULTS
  Older patients comprised 27.1% of our HIV cohort and presented with lower median CD4 T cell counts (65 cells/mm³, interquartile range [IQR]: 27 to 214 cells/mm³) compared to younger patients (250 cells/mm³, IQR: 74 to 400 cells/mm³; P <0.001). The median time from HIV diagnosis to initiation of antiretroviral therapy (ART) differed significantly for both age groups as well (49 days for patients <50 years old, IQR: 18 to 294 days; versus 35 days for patients ≥50 years old, IQR: 14 to 102 days; P = 0.008). More of our younger patients were single (72.2%) or homosexual (44.1%), in contrast to older patients, of whom 48.8% were married and 84.7% were heterosexual.
  
  
  CONCLUSIONS
  Upon comparison of our younger and older patients, we identified distinct differences in risk transmission and clinical presentation. Increased awareness of older patients at risk of HIV may improve time to diagnosis among this age group.
authors.affiliation: Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore.
authors.forename: Linda K
authors.initials: LK
authors.lastname: Lee
authors.forename: Ohnmar Pa Pa
authors.initials: OP
authors.lastname: Seinn
authors.forename: Oon Tek
authors.initials: OT
authors.lastname: Ng
authors.forename: Cheng Chuan
authors.initials: CC
authors.lastname: Lee
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo
authors.forename: Arlene C
authors.initials: AC
authors.lastname: Chua
mesh_terms: D000367:Age Factors; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count / Q000706:statistics & numerical data; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents