Dataset Information

Characteristics and outcomes of older HIV-infected patients receiving antiretroviral therapy in Malawi: A retrospective observation cohort study.

ABSTRACT:

Objective

To estimate patients enrolling on antiretroviral therapy (ART) over time; describe trends in baseline characteristics; and compare immunological response, loss to follow-up (LTFU), and mortality by three age groups (25-39, 40-49 and ?50 years).

Design

A retrospective observation cohort study.

Methods

This study used routine ART data from two public clinics in Lilongwe, Malawi. All HIV-infected individuals, except pregnant or breastfeeding women, aged ? 25 years at ART initiation between 2006 and 2015 were included. Poisson regression models estimated risk of mortality, stratified by age groups.

Results

Of 37,378 ART patients, 3,406 were ? 50 years old. Patients aged ? 50 years initiated ART with more advanced WHO clinical stage and lower CD4 cell count than their younger counterparts. Older patients had a significantly slower immunological response to ART in the first 18 months on ART compared to patients aged 25-39 years (p = 0.04). Overall mortality rates were 2.3 (95% confidence Interval (CI) 2.2-2.4), 2.9 (95% CI 2.7-3.2) and 4.6 (95% CI 4.2-5.1) per 100 person-years in patients aged 25-39 years, 40-49 years and 50 years and older, respectively. Overall LTFU rates were 6.3 (95% CI 6.1-6.5), 4.5 (95% CI 4.2-4.7), and 5.6 (95% CI 5.1-6.1) per 100 person years among increasing age cohorts. The proportion of patients aged ? 50 years and newly enrolling into ART care remained stable at 9% while the proportion of active ART patients aged ?50 years increased from 10% in 2006 to 15% in 2015.

Conclusion

Older people had slower immunological response and higher mortality. Malawi appears to be undergoing a demographic shift in people living with HIV. Increased consideration of long-term ART-related problems, drug-drug interactions and age-related non-communicable diseases is warranted.

SUBMITTER: Tweya H

PROVIDER: S-EPMC5501463 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Characteristics and outcomes of older HIV-infected patients receiving antiretroviral therapy in Malawi: A retrospective observation cohort study.

Tweya Hannock H Feldacker Caryl C Heller Tom T Gugsa Salem S Ng'ambi Wingston W Nthala Omisher O Kalulu Mike M Chiwoko Jane J Banda Rabecca R Makwinja Agness A Phiri Sam S

PloS one 20170707 7

<h4>Objective</h4>To estimate patients enrolling on antiretroviral therapy (ART) over time; describe trends in baseline characteristics; and compare immunological response, loss to follow-up (LTFU), and mortality by three age groups (25-39, 40-49 and ≥50 years).<h4>Design</h4>A retrospective observation cohort study.<h4>Methods</h4>This study used routine ART data from two public clinics in Lilongwe, Malawi. All HIV-infected individuals, except pregnant or breastfeeding women, aged ≥ 25 years at ...[more]

PMID: 28686636

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Dataset Information

Characteristics and outcomes of older HIV-infected patients receiving antiretroviral therapy in Malawi: A retrospective observation cohort study.

Objective

Design

Methods

Results

Conclusion

Publications

Characteristics and outcomes of older HIV-infected patients receiving antiretroviral therapy in Malawi: A retrospective observation cohort study.

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