Association of Age with Mortality and Virological and Immunological Response to Antiretroviral Therapy in Rural South African Adults
2011

Impact of Age on HIV Treatment Outcomes in South Africa

Sample size: 8846 publication 10 minutes Evidence: moderate

Author Information

Author(s): Mutevedzi Portia C., Lessells Richard J., Rodger Alison J., Newell Marie-Louise

Primary Institution: Africa Centre for Health and Population Studies, University of KwaZulu-Natal

Hypothesis

Does age affect treatment outcomes for adults receiving antiretroviral therapy in a rural HIV treatment cohort?

Conclusion

Older adults have higher early mortality rates on antiretroviral therapy compared to younger adults, but mortality rates equalize after one year.

Supporting Evidence

  • Older adults had 32% excess mortality compared to those aged 25-49 years.
  • Overall mortality rates were higher for older adults at 8.69 per 100 person-years.
  • In the first year on ART, older adults had significantly higher mortality rates than younger adults.

Takeaway

Older people getting HIV treatment are more likely to die in the first year than younger people, but after that, their chances of survival are similar.

Methodology

Retrospective cohort analysis of adults initiating ART from August 2004 to October 2009, stratified by age.

Potential Biases

Potential residual confounding by adherence levels or other unmeasured variables.

Limitations

Missing data for follow-up CD4 counts and viral loads may affect results.

Participant Demographics

Participants included 808 young adults (16-24 years), 7119 mid-age adults (25-49 years), and 919 older adults (≥50 years).

Statistical Information

P-Value

0.004

Confidence Interval

95% CI 1.09–1.60

Statistical Significance

p=0.004

Digital Object Identifier (DOI)

10.1371/journal.pone.0021795

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