ArticleJournal of the International AIDS Society2018
Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort.
Article in Journal of the International AIDS Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Systematic review and meta-analysis of retention and disengagement after initiation on antiretroviral therapy in low- and middle-income countries after the introduction of Universal Test and Treat policies.Journal of the International AIDS Society · 2025Pooled it
- Clinical Outcomes of Tenofovir, Lamivudine, and Dolutegravir in Treatment-Naïve versus Treatment-Experienced HIV Patients: A Single-Center Retrospective Cohort Study in Indonesia.Infection & chemotherapy · 2026Article
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- Transitions through the HIV continuum of care in people enrolling in care with advanced HIV disease in Latin America.IJID regions · 2025Article
- Trends in HIV/AIDS-Related Mortality and the Impact of Antiretroviral Treatment Strategies in Lu'an City: A Comprehensive Analysis.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- Non-communicable disease comorbidities in HIV patients: diabetes, hypertension, heart disease, and obstructive sleep apnea as a neglected issue.Scientific reports · 2023Article
- Virologic failure in people living with HIV in 1st line ART: A 10-year Mexican population-based study.International journal of STD & AIDS · 2022Article
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- Factors Influencing Survival Status of HIV/AIDS after HAART in Huzhou City, Eastern China.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2022Article
- Factors associated with viremia in people living with HIV on antiretroviral therapy in Guatemala.AIDS research and therapy · 2021Article
- Antiretroviral therapy and Kaposi's sarcoma trends and outcomes among adults with HIV in Latin America.Journal of the International AIDS Society · 2021Observational
- Associations of menopausal age with virological outcomes and engagement in care among women living with HIV in the UK.HIV research & clinical practice · 2020Article
- Impact of age on CD4 recovery and viral suppression over time among adults living with HIV who initiated antiretroviral therapy in the African Cohort Study.AIDS research and therapy · 2020Article
- Article
- Frequency of non-communicable diseases in people 50 years of age and older receiving HIV care in Latin America.PloS one · 2020Article
- Independent Risk Factors for Deaths due to AIDS in Chongqing, China: Does Age Matter?Frontiers in medicine · 2020Article
- The impact of data quality and source data verification on epidemiologic inference: a practical application using HIV observational data.BMC public health · 2019Article
- Virologic failure and mortality in older ART initiators in a multisite Latin American and Caribbean Cohort.Journal of the International AIDS Society · 2018Article
- Higher Risks of Virologic Failure and All-Cause Deaths Among Older People Living with HIV in Chongqing, China.AIDS research and human retrovirusesArticle
Corrections and comments
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Authors and funding
13 authors at 7 institutions in 7 countries.
Funding
Abstract
introductionThe "greying" of the HIV epidemic necessitates a better understanding of the healthcare needs of older HIV-positive adults. As these individuals age, it is unclear whether comorbidities and their associated therapies or the ageing process itself alter the response to antiretroviral therapy (ART). In this study, HIV treatment outcomes and corresponding risk factors were compared between older ART initiators and those who were younger using data from the Caribbean, Central and South America Network for HIV Epidemiology (CCASAnet).
methodsHIV-positive adults (≥18 years) initiating ART at nine sites in Argentina, Brazil, Chile, Haiti, Honduras, Mexico and Peru were included. Patients were classified as older (≥50 years) or younger (<50 years) based on age at ART initiation. ART effectiveness was measured using three outcomes: death, virologic failure and ART treatment modification. Cox regression models for each outcome compared risk between older and younger patients, adjusting for other covariates.
resultsAmong 26,311 patients initiating ART between 1996 and 2016, 3389 (13%) were ≥50 years. The majority of patients in both ≥50 and <50 age groups received a non-nucleoside reverse transcriptase inhibitor-based regimen (89% vs. 87%), did not have AIDS at baseline (63% vs. 62%), and were male (59% vs. 58%). Older patients had a higher risk of death (adjusted hazard ratio (aHR) 1.64; 95% confidence intervals (CI): 1.48 to 1.83) and a lower risk of virologic failure (aHR: 0.73; 95% CI: 0.63 to 0.84). There was no difference in risk of ART modification (aHR: 1.00; 95% CI: 0.94 to 1.06). Risk factors for death, virologic failure and treatment modification were similar for each group.
conclusionsOlder age at ART initiation was associated with increased mortality and decreased risk of virologic failure in our cohort of more than 26,000 ART initiators in Latin America and the Caribbean. To the best of our knowledge this is the first study from the region to evaluate ART outcomes in this growing and important population. Given the complexity of issues related to ageing with HIV, a greater understanding is needed in order to properly respond to this shifting epidemic.
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