To study the impact of comorbidity on the course of HIV disease in older patients as compared to a matched cohort of younger patients.
In a retrospective case-control study, we compared 43 HIV-infected patients>55 years old to a randomly selected cohort of 86 patients<45 years old, matched by date of HIV diagnosis.
We collected data on non-HIV-related morbidity (as assessed by the Charlson comorbidity index), initiator of HIV testing, HIV stage at time of HIV diagnosis (TOHD), AIDS defining diagnoses, AIDS-related illnesses (ARI), observed AIDS-free interval, survival, and frequency of HIV-related and unrelated hospitalizations.
The older cohort was more likely to have had HIV testing initiated by a heath care provider (36 of 36 versus 50 of 66, P=0.003), and to have acquired HIV from a transfusion (5 of 43 versus 0 of 86, P=0.001), had lower CD4 cell counts at TOHD (205 versus 429, P=0.02), a shorter observed AIDS-free interval (24.0 versus 52.8 months, P=0.0002) and a shorter survival (28.2 versus 58.9 months, P=0.0002).
The older cohort had more HIV-related (13.4 versus 9.2 per 100 patient-months, P=0.024) and non-HIV-related hospitalizations (12.9 versus 8.1 per 100 patient-months, P=0.0001).
The comorbidity index was significantly higher in the older cohort (0.907 versus 0.198, P=0.0001) and was a strong predictor of mortality, independent of age group (risk ratio=1.38 per comorbidity point, P=0.0003). (...)
Mots-clés Pascal : SIDA, Virose, Infection, Virus immunodéficience humaine, Lentivirinae, Retroviridae, Virus, Age, Morbidité, Association, Etude comparative, Mortalité, Adulte jeune, Homme, Adulte, Epidémiologie, Rétrospective, Etude cas témoin, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : AIDS, Viral disease, Infection, Human immunodeficiency virus, Lentivirinae, Retroviridae, Virus, Age, Morbidity, Association, Comparative study, Mortality, Young adult, Human, Adult, Epidemiology, Retrospective, Case control study, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0137232
Code Inist : 002B06D01. Création : 21/05/1997.