Risk factors for mortality during antiretroviral therapy in older populations in resource-limited settings

Journal of the International AIDS Society
Daniel P O'BrienNathan Ford

Abstract

An increasing proportion of adult patients initiating antiretroviral therapy (ART) in resource-limited settings are aged > 50 years. Older populations on ART appear to have heightened risk of death, but little is known about factors influencing mortality in this population. We performed a retrospective observational multisite cohort study including all adult patients (≥ 15 years) initiating ART between 2003 and 2013 in programmes supported by Médecins Sans Frontières across 12 countries in Asia, Africa and Europe. Patients were stratified into two age groups, > 50 years and 15 to 50 years. A Cox proportional hazards model was used to explore factors associated with mortality. The study included 41,088 patients: 2591 (6.3%) were aged > 50 years and 38,497 (93.7%) were aged 15 to 50 years. The mortality rate was significantly higher in the age group > 50 years [367 (14.2%) deaths; mortality rate 7.67 deaths per 100 person-years (95% confidence interval, CI: 6.93 to 8.50)] compared to the age group 15 to 50 years [3788 (9.8%) deaths; mortality rate 4.18 deaths per 100 person-years (95% CI: 4.05 to 4.31)], p < 0.0001. Higher CD4 levels at baseline were associated with significantly reduced mortality rates in the 15 to 50 age group ...Continue Reading

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Citations

Mar 10, 2017·Virulence·Marco RipaGiuseppe Tambussi
Mar 3, 2018·Open Forum Infectious Diseases·Patricia A AgabaPhyllis J Kanki
Oct 27, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Yan ZhaoJulio S G Montaner
Sep 1, 2018·European Journal of Drug Metabolism and Pharmacokinetics·Jessie TorgersenRobert Gross
Apr 5, 2019·AIDS·Sascha AlbrechtUNKNOWN KIULARCO Study Group

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