Marseille 2007
| Abstract #363 - Aging with HIV: newly infected older adults in Lazio Region, Italy | ||||
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Session: 12.4: Ageing and Changeing (Parallel) on Monday @ 11.00-12.30 in PR Chaired by Gerald Gorn, Lorraine Sherr Authors: Presenting Author: Dr nicoletta orchi - INMI Lazzaro Spallanzani, Italy |
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| Additional Authors: dr roberta balzano, Dr assunta navarra, Dr paola elia, Dr gabriella de Carli, Dr paola scognamiglio, Dr vincenzo galati, Dr susanna grisetti, Dr alessandro sanpaolesi, Dr a de filippis, Dr stefano aviani, Dr laura spizzichino, Dr giuseppe ippolito, Dr enrico girardi, | ||||
| Aim: The transition of HIV disease as a progressive fatal to a chronic condition that can often be managed long term, has special ramifications for an aging population, a growing portion of the HIV population. A key issue in the study of HIV/AIDS and aging is to identify and characterize the way in which older adults differ from younger one, having the objective of suggesting the underlying mechanisms that might account for these differences. | ||||
| Method / Issue: A prospective, multi-center study has been conducted in newly-diagnosed HIV-infected adults since 2003 to 2006, in Lazio region, Italy. Demographic and epidemiological information was collected and patients were asked to fill a questionnaire including the following sections : socio-demographic data; health and HIV testing history; sexual behaviour and drug use. Depressive symptoms were evaluated by a Center for Epidemiologic Studies Depression Scale (CES-D) score. We tested whether these characteristics were different between those aged 50 years or older and those aged younger than 50 years with 2 statistics. | ||||
| Results / Comments: 934 patients were enrolled in the study. Of these, 109 persons (11.7%) were aged 50 years or older. For the group aged 50 years or older, 84.4% were male. Median age at enrolment was 36 years (IQR: 30-42; min 18- max 86). Compared with their younger counterparts, older patients were significantly less likely to be foreign born (11.1% vs. 31.9 p<0.001), less likely to have a previous negative test (30.9% vs. 53.1 p<0.001). HIV risk factor differed (2 27.4 p<0.001), with more heterosexual contacts in the older age category (51.5%) and more homosexual one in the younger age (51.9%). Regarding the clinical status of the sample, the study showed statistically significant difference for immunological and virological rates, and for the presence of AIDS-defining condition. In fact, older patients were somewhat more likely to have CD4 cell counts < 350 (76.7% vs. 43.3 p<0.001), viral load >= 100.000 copies/ml (54.0% vs 35.4% p<0.001) and an AIDS-defining disease in the third months after HIV-diagnosis (27.9 vs 12.6 p<0.001). Of the whole sample, 376 persons completed the questionnaire (13.9% older). In a multivariate analysis controlling for sex and origin statistically significant difference by age was found for: education (>5 aa vs >14 OR 7.95 IC 95% 2.2-28.2), having steady partner (yes vs not OR 2.33 IC 95% 1.2-4.7), number of reported sexual partners in the last year (0-1 vs >5 OR 3.41 IC 95% 1.5-7.8), to have pay for sex the last year (yes vs not OR 2.34 IC 95% 1.1-5.1), drug use in life time (not vs yes OR 3.99 IC 95% 1.6-9.6). No significant differences regarding levels of depressive symptoms was found. | ||||
| Discussion: HIV and aging represent a duo with important clinical implications. These findings, if further validated, will have important implications for the clinical management of people aging with HIV infection, underlying the need for greater emphasis on this population that face challenges in terms of concomitant illness and potential for increased morbidity and premature mortality. | ||||
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