In HIV, Risks and Outcomes Differ by Age at Diagnosis

New findings published in HIV Medicine have shed light on distinct risks, clinical characteristics, and outcomes at the time of HIV diagnosis among Canadian patients younger than vs older than age 50 years.

The findings emerged from a retrospective cohort study of all new adult HIV diagnoses in southern Alberta, Canada, that had been made between October 1989 and December 2019. They compared differences in HIV acquisition risk and screening, sociodemographic/clinical characteristics, and causes of death between adults younger and older than age 50 years when they received their HIV diagnosis.

The results of the study indicated that new HIV diagnoses rose from 7% in 1990 to 18% in 2009 among adults older than age 50 years. HIV acquisition risk and reasons for screening differed according to age.

The greatest risk factors were found to be heterosexual sex (29%) among older adults compared with same sex activity (51%) in younger adults. The most common indications for HIV testing were illness (47%) in older adults compared with having requested testing in younger adults (34%).

In addition, 33% of older adults were married to an opposite sex partner compared with 12% of younger adults. Approximately 80% of deaths that occurred between 2010 and 2019 among older adults were due to non-AIDS-related causes compared with 47% of deaths among younger adults. The researchers noted that AIDS‐related deaths and potential years of life lost have decreased among both older and younger adults since 2000.

“The increase in new HIV diagnoses in persons aged > 50 years in southern Alberta suggests that older individuals require customized approaches for optimizing HIV diagnosis and treatment,” the researchers concluded.

—Christina Vogt

Reference:
McMillan JM, Gill MJ, Rubin LH. Distinct risks, clinical characteristics and outcomes by age at time of HIV diagnosis. HIV Med. Published online June 16, 2020. doi:10.1111/hiv.12887