Epidemiological and mortality analysis of older adults with HIV in eastern China

Tiansheng Xie,1,2 Nanping Wu1,2 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Peop...

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Autores principales:	Xie TS, Wu NP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	HIV AIDS older people China. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/97ff89609c5f4b0b811a8c9219c2589b
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spelling	oai:doaj.org-article:97ff89609c5f4b0b811a8c9219c2589b2021-12-02T03:57:21ZEpidemiological and mortality analysis of older adults with HIV in eastern China1178-1998https://doaj.org/article/97ff89609c5f4b0b811a8c9219c2589b2013-11-01T00:00:00Zhttps://www.dovepress.com/epidemiological-and-mortality-analysis-of-older-adults-with-hiv-in-eas-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Tiansheng Xie,1,2 Nanping Wu1,2 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China Objective: The aims of this study were to systematically review epidemiological characteristics in older people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHA) in low endemic areas of the People's Republic of China, analyze the causes of death and mortality, and provide a basis for targeted prevention in these populations. Methods: Nine counties representative of the distribution and epidemiological factors of the HIV epidemic in Zhejiang Province were selected, and data from 1,115 HIV-positive individuals, including 196 older people (≥50 years), who were confirmed as PLWHA from January 1, 2000 to December 31, 2012, were retrospectively analyzed. Results: The proportion of older PLWHA increased from 0% in 2000 to 22.45% in 2012. Sexual transmission was the main route, accounting for 82.65% of infections in this group. Compared with the younger group (range from 14 to 49 years old), the older group had significantly lower CD4+ cell counts (291.64 versus 363.63; P<0.001) when first diagnosed, and more of this group presented in the AIDS state with opportunistic infections (51.02% versus 34.06%; P<0.001). In the older group, 25 (12.76%) patients died directly of AIDS and 171 (87.24%) were censored, and in the younger group 50 (5.44%) patients died directly of AIDS and 869 (94.56%) were censored. Estimated survival time since HIV diagnosis in the older group was 11.54±0.49 years (95% confidence interval [CI] 10.59–12.50), while in the younger group it was 13.85±0.46 years (95% CI 12.94–14.76), the log rank (Mantel–Cox) test gave a chi-square value of 3.83, and there was significant difference between the groups (P<0.05). Conclusion: The number of older PLWHA increased steadily over the study period in low HIV endemic provinces of a developing country. Later discovery and preexisting disease perhaps contributed to a shorter estimated survival time for older PLWHA and higher mortality. Keywords: HIV, AIDS, older people, People's Republic of China, survival analysisXie TSWu NPDove Medical PressarticleHIVAIDSolder peopleChina.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 8, Pp 1519-1525 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	HIV AIDS older people China. Geriatrics RC952-954.6
spellingShingle	HIV AIDS older people China. Geriatrics RC952-954.6 Xie TS Wu NP Epidemiological and mortality analysis of older adults with HIV in eastern China
description	Tiansheng Xie,1,2 Nanping Wu1,2 1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, 2Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, People's Republic of China Objective: The aims of this study were to systematically review epidemiological characteristics in older people living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (PLWHA) in low endemic areas of the People's Republic of China, analyze the causes of death and mortality, and provide a basis for targeted prevention in these populations. Methods: Nine counties representative of the distribution and epidemiological factors of the HIV epidemic in Zhejiang Province were selected, and data from 1,115 HIV-positive individuals, including 196 older people (≥50 years), who were confirmed as PLWHA from January 1, 2000 to December 31, 2012, were retrospectively analyzed. Results: The proportion of older PLWHA increased from 0% in 2000 to 22.45% in 2012. Sexual transmission was the main route, accounting for 82.65% of infections in this group. Compared with the younger group (range from 14 to 49 years old), the older group had significantly lower CD4+ cell counts (291.64 versus 363.63; P<0.001) when first diagnosed, and more of this group presented in the AIDS state with opportunistic infections (51.02% versus 34.06%; P<0.001). In the older group, 25 (12.76%) patients died directly of AIDS and 171 (87.24%) were censored, and in the younger group 50 (5.44%) patients died directly of AIDS and 869 (94.56%) were censored. Estimated survival time since HIV diagnosis in the older group was 11.54±0.49 years (95% confidence interval [CI] 10.59–12.50), while in the younger group it was 13.85±0.46 years (95% CI 12.94–14.76), the log rank (Mantel–Cox) test gave a chi-square value of 3.83, and there was significant difference between the groups (P<0.05). Conclusion: The number of older PLWHA increased steadily over the study period in low HIV endemic provinces of a developing country. Later discovery and preexisting disease perhaps contributed to a shorter estimated survival time for older PLWHA and higher mortality. Keywords: HIV, AIDS, older people, People's Republic of China, survival analysis
format	article
author	Xie TS Wu NP
author_facet	Xie TS Wu NP
author_sort	Xie TS
title	Epidemiological and mortality analysis of older adults with HIV in eastern China
title_short	Epidemiological and mortality analysis of older adults with HIV in eastern China
title_full	Epidemiological and mortality analysis of older adults with HIV in eastern China
title_fullStr	Epidemiological and mortality analysis of older adults with HIV in eastern China
title_full_unstemmed	Epidemiological and mortality analysis of older adults with HIV in eastern China
title_sort	epidemiological and mortality analysis of older adults with hiv in eastern china
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/97ff89609c5f4b0b811a8c9219c2589b
work_keys_str_mv	AT xiets epidemiologicalandmortalityanalysisofolderadultswithhivineasternchina AT wunp epidemiologicalandmortalityanalysisofolderadultswithhivineasternchina
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Epidemiological and mortality analysis of older adults with HIV in eastern China

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