ArticleJournal of acquired immune deficiency syndromes (1999)2014
Mortality and immunological recovery among older adults on antiretroviral therapy at a large urban HIV clinic in Kampala, Uganda.
Article in Journal of acquired immune deficiency syndromes (1999), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Setting priorities for ageing research in Africa: A systematic mapping review of 512 studies from sub-Saharan Africa.Journal of global health · 2021Pooled it
- Observational
- Growing older with HIV in the Treat-All Era.Journal of the International AIDS Society · 2022Article
- Implementing screening for hypertension in archetypal HIV primary care: a mixed-methods assessment.BMC health services research · 2022Article
- Characteristics and treatment outcomes of HIV infected elderly patients enrolled in Kisii Teaching and Referral Hospital, Kenya.African health sciences · 2020Article
- Hypervitaminosis A is associated with immunological non-response in HIV-1-infected adults: a case-control study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- Impact of Efavirenz Metabolism on Loss to Care in Older HIV+ Africans.European journal of drug metabolism and pharmacokinetics · 2019Observational
- The influence of age-associated comorbidities on responses to combination antiretroviral therapy in older people living with HIV.Journal of the International AIDS Society · 2019Observational
- Cumulative viral load as a predictor of CD4+ T-cell response to antiretroviral therapy using Bayesian statistical models.PloS one · 2019Article
- Achieving the fourth 90: healthy aging for people living with HIV.AIDS (London, England) · 2018Article
- Mortality and treatment response amongst HIV-infected patients 50 years and older accessing antiretroviral services in South Africa.BMC infectious diseases · 2018Article
- Article
- Immune recovery of middle-aged HIV patients following antiretroviral therapy: An observational cohort study.Medicine · 2017Observational
- Observational
- HIV Infection in the Elderly: Arising Challenges.Journal of aging research · 2016Review
- Age Differences by Sex in Antiretroviral-Naïve Participants: Pooled Analysis from Randomized Clinical Trials.The Journal of the Association of Nurses in AIDS Care : JANACArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundWe describe older (>50 years) HIV-infected adults after antiretroviral therapy (ART) initiation, evaluating immunological recovery by age category, considering individual trajectories based on the pretreatment CD4. We also describe mortality on ART and its risk factors by age category including the contribution of poor immunological recovery at a large urban clinic in Kampala, Uganda.
methodsWe performed a cohort analysis of adult (>18 years) HIV-infected patients who initiated ART between January 1, 2004 and January 3, 2012. Immunological response was evaluated using mixed-effects linear regression. We described mortality using Kaplan-Meier survival methods analyzing for risk factors of mortality using multivariate Weibull survival regression stratified by age category.
resultsAmong 9806 individuals who initiated ART, mean age was 37 years (SD: 8.8), average follow-up 5.7 years (SD: 1.7), and median baseline CD4 was 115 cells per cubic millimeter (interquartile range: 42-184). Adults younger than 50 years had on average a higher CD4 increase of 45 cells per cubic millimeter (95% confidence interval: 17 to 72; P = 0.001) compared with counterparts aged 60 years and older. Mortality was highest among older adults compared with younger counterparts. Only CD4 count <100 cells per cubic millimeter after 1 year on ART and a CD4 count less than baseline were associated with a statistically significant higher rate of death among older adults.
conclusionsOlder adults had a slower immunological response, which was associated with mortality, but this mortality was not typically associated with opportunistic infections. Future steps would require more evaluation of possible causes of death among these older individuals if survival on ART is to be further improved.
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