title: Older HIV-infected patients--an underestimated population in northern Greece: epidemiology, risk of disease progression and death.
abstract: OBJECTIVE
  HIV prevalence among older people is on the increase. The aim of this study was to evaluate the epidemiological and clinical features at diagnosis and survival of older patients.
  
  
  METHODS
  This was a retrospective analysis of the data of 558 newly diagnosed antiretroviral-naïve patients between January 1998 and December 2008. Patients were divided into two groups according to their age at diagnosis: ≥50 years (n=103) and 18-49 years (n=455).
  
  
  RESULTS
  The most common risk factor for older patients was heterosexual contact (p<0.013). Older patients were more likely to suffer from hypertension (33.0% vs. 5.1%, p<0.0005), cardiovascular disease (20.4% vs. 2.9%, p<0.0005), neurological disorders (11.7% vs. 5.5%, p=0.02), renal dysfunction (12.6% vs. 5.3%, p=0.01), and infections (66.0% vs. 49.7%, p=0.003) than their younger counterparts, and to have more hospital admissions during follow-up (47.5% vs. 19.6%, p<0.0005). Older patients had a shorter survival time (p<0.0005). A statistically significant increase in CD4+ cell number through time was observed in both groups (p<0.0005). Younger patients reached higher magnitudes of absolute numbers of CD4+ cells during follow-up (p<0.0005) after the initiation of antiretroviral therapy. The total number of patients with clinical AIDS from baseline throughout the study period was also higher in the older age group (35.9% vs. 25.0%).
  
  
  CONCLUSIONS
  HIV-infected people aged ≥50 years differ in epidemiological and clinical features to younger HIV-infected people. The issue of increasing prevalence of HIV infection is a matter of concern due to existing comorbidities, which probably lead to higher mortality rates and faster progression to clinical AIDS.
authors: 1(st) Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, 1, Stilponos Kyriakidi Str, 54006, Thessaloniki, Greece. Electronic address: metallidissimeon@yahoo.gr.
authors: Symeon
authors: S
authors: Metallidis
authors: Olga
authors: O
authors: Tsachouridou
authors: Lemonia
authors: L
authors: Skoura
authors: Pantelis
authors: P
authors: Zebekakis
authors: Theofilos
authors: T
authors: Chrysanthidis
authors: Dimitris
authors: D
authors: Pilalas
authors: Isidora
authors: I
authors: Bakaimi
authors: Panagiotis
authors: P
authors: Kollaras
authors: Georgios
authors: G
authors: Germanidis
authors: Aikaterini
authors: A
authors: Tsiara
authors: Antonios
authors: A
authors: Galanos
authors: Nikolaos
authors: N
authors: Malisiovas
authors: Pavlos
authors: P
authors: Nikolaidis
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000276:immunology / Q000401:mortality* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D057210:Delayed Diagnosis; D018450:Disease Progression; D006115:Greece / Q000453:epidemiology; D015497:HIV-1 / Q000276:immunology*; D018451:Homosexuality, Male; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Ageing; Comorbidity; Epidemiology; HIV infection; Survival analysis