More rapid progression to AIDS in older HIV-infected people: the role of CD4+ T-cell counts

J Acquir Immune Defic Syndr (1988). 1991;4(10):970-5.

Abstract

The tendency for older people with HIV infection to progress more rapidly to AIDS than younger people was studied in a group of 111 anti-HIV-positive haemophiliacs followed for up to 10 years from seroconversion. After 7 years of seropositivity, those aged over 30 years at the time of the first positive anti-HIV test had a cumulative progression rate to AIDS of 50%, compared with only 12% for those aged 10-19 years (Kaplan-Meier estimates). Overall, the relative risk of developing AIDS by any given time after seroconversion was 1.45 for each 10 year increase in age (p = 0.002; 95% confidence limits of 1.15, 1.85; Cox proportional hazards model). After adjustment for the CD4+ T-cell count (median of 10 count measurements per patient, fitted as a time-dependent covariate), the relative risk fell to 1.31 but remained statistically significant (p less than 0.05; 95% confidence limits of 1.03, 1.67). This implies that older people may be at higher risk of progression than their younger counterparts, even if their CD4+ T-cell counts are the same. Hence, prophylaxis against opportunistic infections may be indicated at higher CD4+ T-cell counts in older people than in younger people.

MeSH terms

  • Acquired Immunodeficiency Syndrome / blood
  • Acquired Immunodeficiency Syndrome / etiology
  • Acquired Immunodeficiency Syndrome / physiopathology*
  • Adolescent
  • Adult
  • Aged
  • Aging*
  • CD4-Positive T-Lymphocytes / pathology*
  • Child
  • Child, Preschool
  • Follow-Up Studies
  • HIV Infections / blood
  • HIV Infections / etiology
  • HIV Infections / physiopathology*
  • Hemophilia A / complications
  • Hemophilia A / drug therapy
  • Hemophilia A / physiopathology
  • Humans
  • Leukocyte Count*
  • Middle Aged
  • Proportional Hazards Models