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

Ning Han, Stephen T Wright, Catherine C O'Connor, J. Hoy, Sasheela Ponnampalavanar, Miriam Grotowski, H. X. Zhao, A. Kamarulzaman, Australian HIV Observational Database (AHOD) , TREAT Asia HIV Observational Database (TAHOD)

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)152-160
Number of pages9
JournalHIV Medicine
Volume16
Issue number3
DOIs
Publication statusPublished - 1 Mar 2015

Keywords

  • Ageing
  • Asia Pacific
  • Combination antiretroviral therapy
  • HIV infection
  • Older patients
  • Outcomes

Cite this

Han, N., Wright, S. T., O'Connor, C. C., Hoy, J., Ponnampalavanar, S., Grotowski, M., ... TREAT Asia HIV Observational Database (TAHOD) (2015). HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD). HIV Medicine, 16(3), 152-160. https://doi.org/10.1111/hiv.12188
Han, Ning ; Wright, Stephen T ; O'Connor, Catherine C ; Hoy, J. ; Ponnampalavanar, Sasheela ; Grotowski, Miriam ; Zhao, H. X. ; Kamarulzaman, A. ; Australian HIV Observational Database (AHOD) ; TREAT Asia HIV Observational Database (TAHOD). / HIV and aging : Insights from the Asia Pacific HIV Observational Database (APHOD). In: HIV Medicine. 2015 ; Vol. 16, No. 3. pp. 152-160.
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abstract = "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.",
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author = "Ning Han and Wright, {Stephen T} and O'Connor, {Catherine C} and J. Hoy and Sasheela Ponnampalavanar and Miriam Grotowski and Zhao, {H. X.} and A. Kamarulzaman and {Australian HIV Observational Database (AHOD)} and T. Read and M. Bryant and I. Woolley and M. Giles and T. Korman and {TREAT Asia HIV Observational Database (TAHOD)}",
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Han, N, Wright, ST, O'Connor, CC, Hoy, J, Ponnampalavanar, S, Grotowski, M, Zhao, HX, Kamarulzaman, A, Australian HIV Observational Database (AHOD) & TREAT Asia HIV Observational Database (TAHOD) 2015, 'HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD)' HIV Medicine, vol. 16, no. 3, pp. 152-160. https://doi.org/10.1111/hiv.12188

HIV and aging : Insights from the Asia Pacific HIV Observational Database (APHOD). / Han, Ning; Wright, Stephen T; O'Connor, Catherine C; Hoy, J.; Ponnampalavanar, Sasheela; Grotowski, Miriam; Zhao, H. X.; Kamarulzaman, A.; Australian HIV Observational Database (AHOD) ; TREAT Asia HIV Observational Database (TAHOD).

In: HIV Medicine, Vol. 16, No. 3, 01.03.2015, p. 152-160.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - HIV and aging

T2 - Insights from the Asia Pacific HIV Observational Database (APHOD)

AU - Han, Ning

AU - Wright, Stephen T

AU - O'Connor, Catherine C

AU - Hoy, J.

AU - Ponnampalavanar, Sasheela

AU - Grotowski, Miriam

AU - Zhao, H. X.

AU - Kamarulzaman, A.

AU - Australian HIV Observational Database (AHOD)

AU - Read, T.

AU - Bryant, M.

AU - Woolley, I.

AU - Giles, M.

AU - Korman, T.

AU - TREAT Asia HIV Observational Database (TAHOD)

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N2 - 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.

AB - 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.

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KW - Asia Pacific

KW - Combination antiretroviral therapy

KW - HIV infection

KW - Older patients

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DO - 10.1111/hiv.12188

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JO - HIV Medicine

JF - HIV Medicine

SN - 1464-2662

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Han N, Wright ST, O'Connor CC, Hoy J, Ponnampalavanar S, Grotowski M et al. HIV and aging: Insights from the Asia Pacific HIV Observational Database (APHOD). HIV Medicine. 2015 Mar 1;16(3):152-160. https://doi.org/10.1111/hiv.12188