Age Differences by Sex in Antiretroviral-Naïve Participants: Pooled Analysis from Randomized Clinical Trials.
LaRee A Tracy, Kimberly Struble, Cynthia Firnhaber and 7 others
PMID 29475784WHAT IT FOUND
Older adults starting HIV treatment achieved higher viral suppression rates than younger adults.
However, they showed smaller increases in CD4 cell counts. There were no differences in serious laboratory abnormalities between age groups.
Key findings
01Participants aged 50 or older had higher rates of viral suppression at week 48 compared to those 35 or younger, with adjusted odds ratios of 1.60 for women and 1.21 for men.
02Median increases in CD4+ T cell counts from baseline were smaller in older participants compared to younger participants, but the authors state this difference was not clinically relevant.
03No significant differences were observed between younger and older age groups regarding the incidence of Grade 3 or higher laboratory abnormalities, such as liver or kidney issues.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Age was used as a proxy for menopausal status, which may lead to misclassification. The analysis included only antiretrovirals approved before 2010, so results may not apply to newer integrase inhibitor-based regimens. Data on medication adherence was not consistently collected, so the role of adherence in the higher suppression rates among older adults could not be assessed. The comparison groups were not randomly assigned by age, so confounding factors may influence the results despite statistical adjustments.
Declared interests
The authors declared no real or perceived vested interests. The study was supported by NIH and U.S. Government grants.
The easy way to misread this
Do not interpret the smaller CD4+ T cell increases in older adults as a sign of treatment failure. The study found that despite these smaller immune responses, older adults actually had higher rates of viral suppression.