METHOD: The influence of age at infection on progression of human immunodeficiency virus (HIV) disease to different clinical endpoints was studied among 393 HIV-seropositive adults selected from the French SEROCO cohort; follow-up lasted from January 1988 to November 1994. Selected patients had a known date of infection and were enrolled shortly after seroconversion. Age-associated risk ratios (RR) were estimated using the Cox model (age fitted as a continuous variable and RR expressed for each 10-year increment after adjustment for symptomatic primary infection and sexual preference). RESULTS: Age had a weak influence on progression from the date of infection to the first category B event (crude RR = 1.15; adjusted RR = 1.09; 95% confidence interval [CI]: 0.89-1.36) but a marked influence on progression from the first category B to the first category C event (crude RR = 1.95; adjusted RR = 1.97; 95% CI: 1.37-2.79). Similar results were obtained after adjustment for the CD4+ cell count at enrollment. A qualitative CD4+ cell defect could explain the influence of age, but this remains to be confirmed. CONCLUSION: Age at infection should be included in the definition of CD4+ cell count thresholds for clinical management and treatment initiation. Risk factors for progression should be assessed according to the different clinical endpoints.
METHOD: The influence of age at infection on progression of human immunodeficiency virus (HIV) disease to different clinical endpoints was studied among 393 HIV-seropositive adults selected from the French SEROCO cohort; follow-up lasted from January 1988 to November 1994. Selected patients had a known date of infection and were enrolled shortly after seroconversion. Age-associated risk ratios (RR) were estimated using the Cox model (age fitted as a continuous variable and RR expressed for each 10-year increment after adjustment for symptomatic primary infection and sexual preference). RESULTS: Age had a weak influence on progression from the date of infection to the first category B event (crude RR = 1.15; adjusted RR = 1.09; 95% confidence interval [CI]: 0.89-1.36) but a marked influence on progression from the first category B to the first category C event (crude RR = 1.95; adjusted RR = 1.97; 95% CI: 1.37-2.79). Similar results were obtained after adjustment for the CD4+ cell count at enrollment. A qualitative CD4+ cell defect could explain the influence of age, but this remains to be confirmed. CONCLUSION: Age at infection should be included in the definition of CD4+ cell count thresholds for clinical management and treatment initiation. Risk factors for progression should be assessed according to the different clinical endpoints.
Authors: Keri N Althoff; Amy C Justice; Stephen J Gange; Steven G Deeks; Michael S Saag; Michael J Silverberg; M John Gill; Bryan Lau; Sonia Napravnik; Ellen Tedaldi; Marina B Klein; Kelly A Gebo Journal: AIDS Date: 2010-10-23 Impact factor: 4.177
Authors: Amara E Ezeamama; Ezekiel Mupere; James Oloya; Leonardo Martinez; Robert Kakaire; Xiaoping Yin; Juliet N Sekandi; Christopher C Whalen Journal: Int J Infect Dis Date: 2015-04-21 Impact factor: 3.623
Authors: José L Burgos; Julia A Gaebler; Steffanie A Strathdee; Remedios Lozada; Hugo Staines; Thomas L Patterson Journal: PLoS One Date: 2010-06-30 Impact factor: 3.240
Authors: Baba Maiyaki Musa; Usman Gebi; Mary-Ann Etiebet; Helen Omuh; Patrick Ekedegwa; Patrick Dakum; William Blattner Journal: J Public Health Afr Date: 2010-08-19
Authors: Jose L Burgos; Thomas L Patterson; Joshua S Graff-Zivin; James G Kahn; M Gudelia Rangel; M Remedios Lozada; Hugo Staines; Steffanie A Strathdee Journal: PLoS One Date: 2016-02-18 Impact factor: 3.752