HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)

TREAT Asia HIV Observational Database (TAHOD)

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.

Original languageEnglish
Pages (from-to)152-160
Number of pages9
JournalHIV Medicine
Volume16
Issue number3
DOIs
Publication statusPublished - 2015 Mar 1

Fingerprint

HIV
Databases
CD4 Lymphocyte Count
Viral Load
Confidence Intervals
Therapeutics
Acquired Immunodeficiency Syndrome
Regression Analysis
Survival
Mortality
Population

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Infectious Diseases
  • Pharmacology (medical)

Cite this

TREAT Asia HIV Observational Database (TAHOD). / HIV and aging : Insights from the Asia Pacific HIV Observational Database (APHOD). In: HIV Medicine. 2015 ; Vol. 16, No. 3. pp. 152-160.
@article{e6a738f5c2a64595b267df5503f69b9e,
title = "HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)",
abstract = "Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60{\%} in TAHOD and 40{\%} in AHOD), of whom 25{\%} were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95{\%} confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95{\%} CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.",
author = "{TREAT Asia HIV Observational Database (TAHOD)} and N. Han and Wright, {S. T.} and O'Connor, {C. C.} and J. Hoy and S. Ponnampalavanar and M. Grotowski and Zhao, {H. X.} and A. Kamarulzaman and D. Ellis and M. Bloch and T. Franic and S. Agrawal and L. McCann and N. Cunningham and T. Vincent and D. Allen and Little, {J. L.} and D. Smith and C. Gray and D. Baker and R. Vale and Templeton, {D. J.} and C. Dijanosic and E. Jackson and K. McCallum and S. Taylor and D. Cooper and A. Carr and F. Lee and K. Hesse and K. Sinn and R. Norris and R. Finlayson and I. Prone and J. Shakeshaft and K. Brown and C. McGrath and V. McGrath and S. Halligan and L. Wray and P. Read and H. Lu and D. Couldwell and V. Furner and J. Watson and C. Lawrence and B. Mulhall and Matthew Law and K. Petoumenos and H. McManus",
year = "2015",
month = "3",
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doi = "10.1111/hiv.12188",
language = "English",
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pages = "152--160",
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TREAT Asia HIV Observational Database (TAHOD) 2015, 'HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)', HIV Medicine, vol. 16, no. 3, pp. 152-160. https://doi.org/10.1111/hiv.12188

HIV and aging : Insights from the Asia Pacific HIV Observational Database (APHOD). / TREAT Asia HIV Observational Database (TAHOD).

In: HIV Medicine, Vol. 16, No. 3, 01.03.2015, p. 152-160.

Research output: Contribution to journalArticle

TY - JOUR

T1 - HIV and aging

T2 - Insights from the Asia Pacific HIV Observational Database (APHOD)

AU - TREAT Asia HIV Observational Database (TAHOD)

AU - Han, N.

AU - Wright, S. T.

AU - O'Connor, C. C.

AU - Hoy, J.

AU - Ponnampalavanar, S.

AU - Grotowski, M.

AU - Zhao, H. X.

AU - Kamarulzaman, A.

AU - Ellis, D.

AU - Bloch, M.

AU - Franic, T.

AU - Agrawal, S.

AU - McCann, L.

AU - Cunningham, N.

AU - Vincent, T.

AU - Allen, D.

AU - Little, J. L.

AU - Smith, D.

AU - Gray, C.

AU - Baker, D.

AU - Vale, R.

AU - Templeton, D. J.

AU - Dijanosic, C.

AU - Jackson, E.

AU - McCallum, K.

AU - Taylor, S.

AU - Cooper, D.

AU - Carr, A.

AU - Lee, F.

AU - Hesse, K.

AU - Sinn, K.

AU - Norris, R.

AU - Finlayson, R.

AU - Prone, I.

AU - Shakeshaft, J.

AU - Brown, K.

AU - McGrath, C.

AU - McGrath, V.

AU - Halligan, S.

AU - Wray, L.

AU - Read, P.

AU - Lu, H.

AU - Couldwell, D.

AU - Furner, V.

AU - Watson, J.

AU - Lawrence, C.

AU - Mulhall, B.

AU - Law, Matthew

AU - Petoumenos, K.

AU - McManus, H.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.

AB - Objectives: The proportion of people living with HIV/AIDS in the ageing population (>50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods: Patients from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy (cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results: A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were >50 years old. In multivariable analyses, those aged >50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio (HR) for 50-59 years: 2.27; 95% confidence interval (CI) 1.34-3.83; HR for >60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend=0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend=<0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend=0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions: The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting.

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DO - 10.1111/hiv.12188

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