icon_folder.gif   Conference Reports for NATAP  
  9th Conference on Retroviruses and Opportunistic Infections
Seattle, Washington, February, 2002
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Do Older Folks (>50) Progress More Quickly
Reported by Jules Levin
  A research group at John Hopkins looked at the death rate in people over 50 vs people under 50 years of age, and the impact of HAART. For background information the researchers (Perez and Moore, abstract 472-M) said older people progress more quickly with HIV, have a blunted CD4 count increase following HAART than younger folks. Since there is little information on treatment in older folks, these researchers undertook this syudy.
259 folks over 50 years of age and 538 individuals <50 years of age were randomly selected from 2500 patients from an urban HIV clinic being followed from 1989-2001. On average, they followed patients for 3 years. Both older and younger patients had high viral loads before therapy, but older patients had a higher CD4 count on average (200 vs 136).
Older folks (n=113) who were not treated for HIV had a lower chance of survival than younger patients who were not treated for HIV (n=273), p<0.0001. The cumulative proportion of older individuals surviving was 13% if untreated and the proportion of younger individuals surviving who were untreated was 31%. Both older and younger individuals who did receive HIV treatment had the same 72% proportion surviving. The older group was more likely to be male and not homosexual.
The authors concluded that older folks over 50 years of age who were not treated with HAART had more than double the risk of death than untreated younger patients. These data suggest the benefit from HAART on survivial is greater in older than younger individuals and emphasize the importance of treatment for older individuals.
Editorial note: delaying HIV therapy appears to be more risky in older individuals.