Virologic failure and all-cause mortality among older people living with HIV/AIDS in South China

ABSTRACT

This retrospective cohort study investigated older people living with HIV/AIDS (PLWHA) characteristics, HIV care, and treatment outcomes among all cases between 1996 and 2019 in Guangxi, China. Secondary data were extracted from two national surveillance databases. Older (≥50 years old) and younger (18-49 years old) PLWHA were compared regarding demographic and behavioral characteristics, HIV care, virologic failure, and all-cause mortality. Older PLWHA accounted for 41.6% of all HIV cases (N = 144,952) between 1996 and 2019. The proportion of older cases increased from 10.4% to 64.8% for men and from 2.4% to 66.7% for women between 2002 and 2019. Heterosexual contact accounted for 96.0% of older adults. Moreover, older PLWHA had a lower median CD4 count at the HIV diagnosis (193 vs. 212 cells/μL, p < 0.0001) and were less likely to receive antiretroviral therapy (ART) than younger adults (72.1% vs. 86.1%, p < 0.001). The all-cause mortality risk of older PLWHA was 2.87 times of younger adults [adjusted hazard ratio (AHR) 2.87; 95% confidence interval (CI) 2.76-2.98]. In addition, older PLWHA reported an 18% increase in odds for virologic failure than younger adults (AOR 1.18; 95% CI 1.08-1.30). Therefore, enhanced HIV prevention and care are urgently needed in older people.

KEYWORDS:

• HIV/AIDS
• older people
• virologic failure
• mortality

Disclosure statement

No potential conflict of interest was reported by the author(s).

Role of the funding source

The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the paper. The corresponding author has full access to all data in the study and takes final responsibility for the decision to submit for publication.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [82160636, 11971479], Guangxi Natural Science Foundation Project (grants 2020GXNSFAA159020), Guangxi Key Laboratory of AIDS Prevention Control and Translation [ZZH2020010], Ministry of Science and Technology of China [2018ZX10721102-006, 2018ZX10715008], Guangxi Bagui Honor Scholarship, and Chinese State Key Laboratory of Infectious Disease Prevention and Control.