ABSTRACT

1. Influence of Age in the Progression of HIV Infection in Females: Results from the Wings Clinic Women’s Cohort (WCWC) Study Syed T. Hussain, MD; Srinivas Uppatla, MD; Kendra Thomson; Bobbi Andriakos; Diana Christensen, MD; Raul Nakamatsu, MD Division of Infectious Diseases, University of Louisville RESULTS RESULTS (Cont’d) ABSTRACT OBJECTIVE of STUDY INTRODUCTION: The population of HIV patients in the United States is aging. Several host factors may influence the progression of HIV infection. The role of age in the progression of HIV infected females is not well described. The objective of this study is to determine the influence of age in the progression of HIV infection in females. METHODS: This was a retrospective observational study of HIV-infected female patients managed at the Wings Clinic in Louisville, KY from 2006 to 2011. Patients where characterized as older adults (age >50) and young adults (age 18-50). Progression of HIV disease was evaluated using a linear mixed effects regression model examining the relationship between median CD4+ cell count each year in each of the two age groups. RESULTS: Total of 164 patients were included in the study. We found 117 (71%) patients were ≤ 50 years of age and 47 (29%) patients were >50 years of age. The results of the regression model showed the progression of HIV disease in both age groups were similar over time (P=0.487). CONCLUSION: This study showed that age does not influence HIV progression in females. As the HIV population continues to age, physicians will be more frequently confronted with older HIV patients. Physicians should not overemphasize patient age when predicting the progression of HIV disease in these female patients • A total of 164 patients were included in our study. Patient demographics is shown in Table 1. • Absolute CD4 T lymphocyte count is shown in Table 2. • The results of the regression model showed that the progression of HIV disease in both age groups were similar over time (Figure 1). The objective of this study is to determine the influence of age in the progression of HIV infection in females. MATERIALS AND METHODS Study design and Study population • This was a retrospective observational study of HIV-infected female patients. Patients were managed at Wings Clinic in Louisville, KY from 2006 to 2011. • Data was collected from an electronic medical records of Wings Clinic, Division of Infectious Disease, University of Louisville. • Study data was managed using REDCap3 electronic data capture tools hosted at University of Louisville, Clinical and Translational Research Support Center. • Progression of HIV was defined in our study by the declining CD4 T lymphocyte count. • Patients where characterized as older adults (age >50) and young adults (age 18-50). Figure 1.Influence of age in the progression of HIV infection in females. CONCLUSIONS • The average absolute CD4 count in patients ≤ 50 years was lower than in patients > 50 years of age. • There was no difference in progression to HIV in both groups of patients.  • Elderly female patients infected with HIV do not have an increased risk of progression to HIV. One possible explanation is improve adherence to treatmentas compared to younger infected females. • As the HIV population continues to age, physicians will be more frequently confronted with older HIV patients. Physicians should not overemphasize patient age when predicting the progression of HIV disease in these female patients INTRODUCTION • HIV population in the United States is increasing,largely in part due to a steady increase in the survival of HIV patients who are now aging.1 • Studies have shown a decrease in Absolute CD4 T lymphocyte count in HIV patients above 50 years of age indicating as age being a cofactor in HIV progression.2 • There has also been a difference of progression of HIV Infection in different gender patient population with female having a more rapid progression of the disease. • The role of age in the progression of HIV infected females is not well described. • Statistical Analysis: • Progression of HIV disease was evaluated using a linear mixed effects regression model examining the relationship between median CD4+ cell count and age (≤50 years and >50 years). REFERENCES • High KP, Brennan-Ing M, Clifford DB, et al. HIV and aging: state of knowledge and areas of critical need for research. A report to the NIH Office of AIDS Research by the HIV and Aging Working Group. J Acquir Immune DeficSyndr. Jul 1 2012;60 Suppl 1:S1-18. • PezzottiP, Phillips AN, Dorrucci M, et al. Category of exposure to HIV and age in the progression to AIDS: longitudinal study of 1199 people with known dates of seroconversion. HIV Italian Seroconversion Study Group. BMJ. Sep 7 1996;313(7057):583-586. • Paul A. Harris, Robert Taylor, Robert Thielke, Jonathon Payne, Nathaniel Gonzalez, Jose G. Conde, Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support, J Biomed Inform. 2009 Apr;42(2):377-81.