Background: This study was
undertaken to address the controversy regarding immunologic response to
combination antiretroviral therapy (cART) among older patients. Methods: In a
cross-sectional study all patients attending the HIV Clinic at Imam Khomeini
Hospital (Tehran) from 2010 to 2011 were evaluated. Immunologic response was
investigated using consecutive CD4+ T-cell counts in a one-year interval and
outcomes were analyzed for older (>=50 yrs) and younger (<50 yrs)
patients using SPSS version 16.0. Results: A total of 714 patients were
actively enrolled in the clinic while 24 were 50 years or older, and had initiated
ART; a similar random group of younger patients was selected as the control.
Hepatitis C was the most prevalent co-infection in both groups. Patients with
no serologic evidence of hepatitis B and C had significantly higher CD4+ T-cell
counts than HIV/HBV co-infected patients after 12 months (p = 0.04). The average
increased CD4+ T-cell counts in 6, 9, and 12 months of cART initiation were
lower among older patients but the difference was not significant (50.75 vs.
123.08; p = 0.37, 132.87 vs. 710.58; p = 0.25, 271.27 vs. 500; p = 0.65). Conclusion:
About 11% of the registered HIV-positive patients at our clinic were 50 years
or older while their immunologic response to cART showed to be different.
Specific needs of older HIV infected patients are highly recommended to be
addressed in future treatment and care programs.
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