Clinical characteristics and antiretroviral treatment of older HIV-infected patients

Background The number of Human Immunodeficiency Virus (HIV) patients aged 50 years or over is growing year on year, due to both late diagnoses and the chronicity of the illness. This increase is a new phenomenon. Objective To describe the clinical and epidemiological characteristics of the older HIV infected population and determine if there are differences in antiretroviral treatment between younger and older patients. Setting This study was conducted in the outpatient hospital pharmacy service of a University Hospital in Spain. Method A descriptive study involving HIV infected patients aged 50 years or older who received ambulatory antiretroviral therapy between January and December 2011. Variables related to HIV and to antiretroviral therapy were collected. A comparison of antiretroviral drugs used was made with the populations older and younger than 50 years. Main outcome measure Antiretroviral therapy differences between older and younger HIV-patients. Results 130 patients (20 % of the antiretroviral treated patients) were 50 or over and 77 % of these was aged between 50 and 59. At the time of diagnosis, 50 % suffered an advanced state of disease. At the end of the study period, 58 % had CD4 lymphocyte levels of over 500 cells/mm³ and 90 % had an undetectable viral load. The antiretroviral therapy of the older group that was based on protease inhibitors was used in the 51.5 % of the patients compared with 54.4 % in the younger group. The figures for nonnucleoside reverse transcriptase inhibitors based therapy were 43.8 and 39.8 %, respectively. The older population used treatments that included tenofovir (56.9 vs. 64.8 %, p = 0.105) less frequently and used more treatments that included abacavir (26.9 vs. 19.1 %, p = 0.054) than the under 50′s. Conclusion Half the older HIV-infected patients were diagnosed with an advanced disease and the majority showed a positive response to antiretroviral therapy. There are no statistically significant differences between the frequency of antiretroviral therapy use in older and younger HIV-patients, although older HIV-patients has less often used treatments with tenofovir and more often used treatments with abacavir.