HIV and aging: insights from the Asia Pacific HIV Observational Database ( APHOD).

Objectives The proportion of people living with HIV/ AIDS in the ageing population (> 50 years old) is increasing. We aimed to explore the relationship between older age and treatment outcomes in HIV-positive persons from the Asia Pacific region. Methods Patients from the Australian HIV Observational Database ( AHOD) and the TREAT Asia HIV Observational Database ( TAHOD) were included in the analysis. We used survival methods to assess the association between older age and all-cause mortality, as well as time to treatment modification. We used regression analyses to evaluate changes in CD4 counts after combination antiretroviral therapy ( cART) initiation and determined the odds of detectable viral load, up to 24 months of treatment. Results A total of 7142 patients were included in these analyses (60% in TAHOD and 40% in AHOD), of whom 25% were > 50 years old. In multivariable analyses, those aged > 50 years were at least twice as likely to die as those aged 30-39 years [hazard ratio ( HR) for 50-59 years: 2.27; 95% confidence interval ( CI) 1.34-3.83; HR for > 60 years: 4.28; 95% CI 2.42-7.55]. The effect of older age on CD4 count changes was insignificant (p-trend = 0.06). The odds of detectable viral load after cART initiation decreased with age (p-trend = < 0.0001). The effect of older age on time to first treatment modification was insignificant (p-trend = 0.21). We found no statistically significant differences in outcomes between AHOD and TAHOD participants for all endpoints examined. Conclusions The associations between older age and typical patient outcomes in HIV-positive patients from the Asia Pacific region are similar in AHOD and TAHOD. Our data indicate that 'age effects' traverse the resource-rich and resource-limited divide and that future ageing-related findings might be applicable to each setting. [ABSTRACT FROM AUTHOR]