ArticlePloS one2014
Antiretroviral treatment outcomes amongst older adults in a large multicentre cohort in South Africa.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- The HIV care cascade in sub-Saharan Africa: systematic review of published criteria and definitions.Journal of the International AIDS Society · 2021Pooled it
- Comparison of Antiretroviral Therapy Adherence Among HIV-Infected Older Adults with Younger Adults in Africa: Systematic Review and Meta-analysis.AIDS and behavior · 2019Pooled it
- Trends in frequency of HIV viral load and CD4 cell count monitoring among Asian cohort of adults with HIV: an analysis of the TREAT Asia HIV Observational Database, 2003-2018.medRxiv : the preprint server for health sciences · 2026Article
- Cause-specific hazards of antiretroviral therapy programmatic adherence, defaulting and mortality among HIV/AIDS patients who had attained CD4 count recovery after antiretroviral therapy initiation in South Africa.Frontiers in reproductive health · 2026Article
- Determinants of CD4 count recovery among severely immunosuppressed HIV patients initiated on antiretroviral therapy: a prospective cohort study in KwaZulu-Natal, South Africa.Frontiers in public health · 2026Article
- Aging and HIV: Recent Findings in Contributing Factors.AIDS research and treatment · 2025Review
- Article
- Prevalence, Predictors, and Outcomes of HIV Care in HIV-Positive Clients Entering HIV Care With Advanced HIV Disease in Sub-Saharan Africa 2010-2022: Systematic Review and Meta-Analysis.Health science reports · 2024Article
- Loss to follow-up among people living with HIV on tuberculosis preventive treatment at four regional referral hospitals, Uganda, 2019-2021.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Clinico-demographic and survival profile of people living with HIV on antiretroviral treatment.Frontiers in public health · 2023Article
- Barriers and facilitators to the utilization of the intensive adherence counselling framework by healthcare providers in Uganda: a qualitative study.BMC health services research · 2022Article
- Unsuppressed viral load after intensive adherence counselling in rural eastern Uganda; a case of Kamuli district, Uganda.BMC public health · 2021Article
- "A NOWADAYS DISEASE": HIV/AIDS AND SOCIAL CHANGE IN A RURAL SOUTH AFRICAN COMMUNITY.AJS; American journal of sociology · 2021Article
- A Multi-Dimensional Characterization of Aging and Wellbeing Among HIV-Positive Adults in Malawi.AIDS and behavior · 2021Article
- Article
- Treatment outcomes in HIV infected patients older than 50 years attending an HIV clinic in Harare, Zimbabwe: A cohort study.PloS one · 2021Article
- Characteristics and outcomes of older people on antiretroviral therapy in Tlokwe Clinics, South Africa.Southern African journal of HIV medicine · 2020Article
- Dopaminergic impact of cART and anti-depressants on HIV neuropathogenesis in older adults.Brain research · 2019Review
- Article
- Loss to follow-up from antiretroviral therapy clinics: A systematic review and meta-analysis of published studies in South Africa from 2011 to 2015.Southern African journal of HIV medicine · 2019Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionIncreasing numbers of patients are starting antiretroviral treatment (ART) at advanced age or reaching advanced age while on ART. We compared baseline characteristics and ART outcomes of older adults (aged ≥55 years) vs. younger adults (aged 25-54 years) in routine care settings in South Africa.
methodsA multicentre cohort study of ART-naïve adults starting ART at 89 public sector facilities was conducted. Mortality, loss to follow-up (LTFU), immunological and virological outcomes until five years of ART were compared using competing-risks regression, generalised estimating equations and mixed-effects models.
results4065 older adults and 86,006 younger adults were included. There were more men amongst older adults; 44.7% vs. 33.4%; RR = 1.34 (95% CI: 1.29-1.39). Mortality after starting ART was substantially higher amongst older adults, adjusted sub-hazard ratio (asHR) = 1.44 over 5 years (95% CI: 1.26-1.64), particularly for the period 7-60 months of treatment, asHR = 1.73 (95% CI: 1.44-2.10). LTFU was lower in older adults, asHR = 0.87 (95% CI: 0.78-0.97). Achievement of virological suppression was greater in older adults, adjusted odds ratio = 1.42 (95% CI: 1.23-1.64). The probabilities of viral rebound and confirmed virological failure were both lower in older adults, adjusted hazard ratios = 0.69 (95% CI: 0.56-0.85) and 0.64 (95% CI: 0.47-0.89), respectively. The rate of CD4 cell recovery (amongst patients with continuous viral suppression) was 25 cells/6 months of ART (95% CI: 17.3-33.2) lower in older adults.
conclusionsAlthough older adults had better virological outcomes and reduced LTFU, their higher mortality and slower immunological recovery warrant consideration of age-specific ART initiation criteria and management strategies.
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Registered trials
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