title: Combined effect of sex and age in response to antiretroviral therapy in HIV-infected patients.
abstract: Gender-specific data on the management of HIV infection are scarce. Further, an increase in the proportion of new HIV diagnoses in older persons has been observed. Using data from the CoRIS cohort, we compared immunovirological responses and survival in HIV-infected men and women who started their first combination antiretroviral therapy (cART) when aged < /≥50 years.
  
  
  
  We used multivariable logistic, linear and Cox regression, adjusting for potential confounders and including an interaction between age and sex, to assess differences in immunovirological responses and mortality, respectively.
  
  
  
  At 96 weeks, among subjects <50 years, women were less likely than men to achieve virological response (VR; adjusted OR [aOR] 0.77, 95% CI 0.60, 0.99) and among women, older individuals were more likely to achieve VR than the younger ones (aOR 1.96; 95% CI 1.15, 3.34). Initiating cART at ≥50 years was associated with lower increases in CD4+T-cell count both in men (-65.8; 95% CI -91.3, -40.3) and women (-37.7; 95% CI -79.7, 4.4) and women showed higher increases than men in both subjects aged <50 (21.8; 95% CI -1.9, 45.5) and ≥50 years at cART initiation (49.9; 95% CI 19.9, 79.9). A higher risk of death in men ≥50 was observed (adjusted hazard ratio [aHR] 2.69; 95% CI 1.73, 4.21), but not in women (aHR 1.49; 95% CI 0.70, 1.14). Women experienced lower mortality than men <50 (0.66; 95% CI 0.41, 1.07) and in those ≥50 (0.37; 95% CI 0.14, 0.93).
  
  
  
  Sex and age at cART initiation have a noticeable association with both virological and immunological responses and mortality. Age ≥50 is associated with poorer immunological response and higher mortality but this effect is less pronounced in women than in men.
authors.affiliation: Hospital San Pedro-CIBIR, Logroño, Spain.
authors.forename: Jose Ramón
authors.initials: JR
authors.lastname: Blanco
authors.affiliation: Red de Investigación en SIDA, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.|CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Inma
authors.initials: I
authors.lastname: Jarrin
authors.affiliation: Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
authors.forename: Maria Jesús
authors.initials: MJ
authors.lastname: Pérez-Elías
authors.affiliation: Hospital General de Elche & Universidad Miguel Hernández, Alicante, Spain.
authors.forename: Félix
authors.initials: F
authors.lastname: Gutiérrez
authors.affiliation: Hospital San Cecilio, Granada, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Quero
authors.affiliation: Hospital General Alicante, Alicante, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Portilla
authors.affiliation: Hospital Universitari MutuaTerrasa, Terrasa, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Dalmau
authors.affiliation: Hospital Ramón y Cajal, IRYCIS, Madrid, Spain.
authors.forename: Santiago
authors.initials: S
authors.lastname: Moreno
authors.affiliation: Red de Investigación en SIDA, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.|CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Victoria
authors.initials: V
authors.lastname: Hernando
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012737:Sex Factors; D013030:Spain; D000072230:Sustained Virologic Response
chemical_list: D019380:Anti-HIV Agents