期刊
AIDS RESEARCH AND THERAPY
卷 7, 期 -, 页码 -出版社
BMC
DOI: 10.1186/1742-6405-7-45
关键词
-
资金
- National Institutes of Health [U01-AI069918, U01-AA013566, U01-AI31834, U01-AI34989, U01-AI34993, U01-AI34994, U01-AI35004, U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, U01-AI35043, U01-AI37613, U01-AI37984, U01-AI38855, U01-AI38858, U01-AI42590, U01-AI68634]
- Centers for Disease Control [CDC200-2006-18797]
- Canadian Institutes for Health Research [CIHR: TGF-96118, HCP-97105, CBR-86906, CBR-94036, KRS-86251, 169621]
- Canadian Trials Network [242]
- NIH [U01-AI68636, U01-HD32632, M01-RR00071, M01-RR00079, M01-RR00083, M01-RR00722, P30-AI27757, P30-AI27767, P30-AI50410, P30-AI54999, R01-DA04334, R01-DA12568, R01-MH54907, R24-AI067039, Z01-CP010176, AHQ290-01-0012, N02-CP55504]
- N.I.H. [R01-DA11602, AI-69432, K01-AI071754, R01-AA16893, K24-00432, K23-AI-61-0320]
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [K01AI071725, P30AI050410, U01AI069918] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON DRUG ABUSE [R56DA004334, R01DA004334] Funding Source: NIH RePORTER
We assessed CD4 count at initial presentation for HIV care among >= 50-year-olds from 1997-2007 in 13 US and Canadian clinical cohorts and compared to <50-year-olds. 44,491 HIV-infected individuals in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) were included in our study. Trends in mean CD4 count (measured as cells/mm(3)) and 95% confidence intervals ([,]) were determined using linear regression stratified by age category and adjusted for gender, race/ethnicity, HIV transmission risk and cohort. From 1997-2007, the proportion of individuals presenting for HIV care who were >= 50-years-old increased from 17% to 27% (p-value < 0.01). The median CD4 count among >= 50 year-olds was consistently lower than younger adults. The interaction of age group and calendar year was significant (p-value < 0.01) with both age groups experiencing modest annual improvements over time (< 50-year-olds: 5[4, 6] cells/mm(3); >= 50-year-olds: 7[5, 9] cells/mm(3)), after adjusting for sex, race/ethnicity, HIV transmission risk group and cohort; however, increases in the two groups were similar after 2000. A greater proportion of older individuals had an AIDS-defining diagnosis at, or within three months prior to, first presentation for HIV care compared to younger individuals (13% vs. 10%, respectively). Due to the increasing proportion, consistently lower CD4 counts, and more advanced HIV disease in adults >= 50-year-old at first presentation for HIV care, renewed HIV testing efforts are needed.
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