TITLE

CD4 count at presentation for HIV care in the United States and Canada: Are those over 50 years more likely to have a delayed presentation?

AUTHOR(S)
Althoff, Keri N.; Gebo, Kelly A.; Gange, Stephen J.; Klein, Marina B.; Brooks, John T.; Hogg, Robert S.; Bosch, Ronald J.; Horberg, Michael A.; Saag, Michael S.; Kitahata, Mari M.; Eron, Joseph J.; Napravnik, Sonia; Rourke, Sean B.; Gill, M. John; Rodriguez, Benigno; Sterling, Timothy R.; Deeks, Steven G.; Martin, Jeffrey N.; Jacobson, Lisa P.; Kirk, Gregory D.
PUB. DATE
January 2010
SOURCE
AIDS Research & Therapy;2010, Vol. 7, p45
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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/mm³) 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/mm³; ≥50-year-olds: 7[5 , 9] cells/mm³), 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.
ACCESSION #
57783811

 

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