10/15/10

UK:  HIV Transmission and High Rates of Late Diagnoses Among Adults Aged 50 Years and Over

The authors of the current study aimed to describe the epidemiology and impact of late HIV diagnosis among older adults and to estimate the age at which they became infected.

The research team undertook comparative national analyses between individuals diagnosed at age 50 and older versus those diagnosed at ages younger than 50. CD4 cell count at diagnosis was used to estimate age at time of infection.

In 2007, 8,255 older adults accessed HIV care in England, Wales, and Northern Ireland. This represented a 3.5-fold increase compared to 2000, and one in 10 patients were newly diagnosed in 2007.

Compared with adults diagnosed at younger ages, older adults were significantly more likely to be men (74 percent vs. 58 percent; P<0.001), to be infected through sex between men (40 percent vs. 34 percent; P<0.001), and of white ethnicity (60 percent vs. 38 percent; P<0.001).

Older heterosexuals were more likely to be infected within the United Kingdom (16 percent vs. 12 percent; P<0.001), with evidence of travel abroad among white heterosexual men. Forty-eight percent of older patients were late presenters, compared to 33 percent of younger adults. Older patients who were late presenters were 14 times more likely to die within one year of diagnosis, compared to older patients who were not diagnosed late (14 percent vs. 1 percent; P<0.001), and their risk of dying was 2.4 times greater than that of younger late presenters.

"We estimate that nearly half (48 percent) of older adults diagnosed between 2000 and 2007 acquired their infection at age 50 and over," the authors wrote.

"Our study provides evidence of HIV transmission, high rates of late presentation, and an increased risk of short-term mortality among older adults. These findings highlight the need for increased targeted prevention efforts and strategies to increase HIV testing among older adults at risk of HIV."

Source: AIDS Vol. 24; No. 13: P. 2109-2115 (08.24.10):: Ruth D. Smith; Valerie C. Delpech; Alison E. Brown; Brian D. Rice; Courtesy of the CDC National Center for HIV, STD, and TB Prevention