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Long-Term Mortality in HIV-Infected Individuals 50 Years or Older: A Nationwide, Population-Based Cohort Study
Abstract
BACKGROUND: Although the prevalence of HIV-infection among individuals ≥ 50 years of age has increased, the impact of HIV-infection on risk of death in this population remains to be established. Our aim was to estimate long-term mortality among HIV-infected individuals who were 50 years or older, when compared with an individually-matched cohort from the background population. METHODS: Population-based cohort-study including HIV-infected individuals ≥ 50 years, who were alive 1 year after HIV-diagnosis (n = 2440) and a comparison cohort individually-matched by age and gender extracted from the background population (n = 14,588). Cumulative survival was evaluated using Kaplan-Meier method and Mortality Rate Ratios (MRRs) were estimated using Cox Regression Models. Study period 1996-2014. RESULTS: Estimated median survival time from age 50 years for HIV-infected individuals increased from 11.8 years (95% CI: 10.2 to 14.5) during 1996-1999 to 22.8 years (20.0-24.2) in 2006-2014. MRR decreased with increasing age from 3.8 (3.1-4.7) for 50-55 years to 1.6 (1.0-2.6) for 75-80 years. In a cohort of well-treated HIV-infected individuals ≥ 50 years without AIDS-defining events or comorbidity at study inclusion (n = 517). MRR was 1.7 (1.2-2.3) compared with population controls without comorbidity. CONCLUSION: Among HIV-infected individuals estimated median survival time from age 50 years has increased by more than 10 years from 1996-1999 to 2006-2014, but is still substantially lower than in the background population. Even among well-treated HIV-infected individuals ≥ 50 years without comorbidity or AIDS-defining events the estimated median survival time remains lower than in the general population.
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“Effective ART that suppresses HIV replication to undetectable levels reduces morbidity, provides a near-normal lifespan, and prevents sexual transmission of HIV to others (95–97,410–412).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [410]
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Self-citationRodriguez-Penney, A. T., Iudicello, J. E., Riggs, P. K., Doyle, K. L., Ellis, R. J., Letendre, S. L., Grant, I., & Woods, A. T. H. N. S. P. (2013) · AIDS Patient Care and STDs · doi:10.1089/apc.2012.0329 · Cited by 323
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Self-citationResponse to combination antiretroviral therapy: variation by age
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Sexually Transmitted Infections Treatment Guidelines, 2021
Workowski, K. A., Bachmann, L. H., Chan, P. A., Johnston, C. M., Muzny, C. A., Park, I., Reno, H., Zenilman, J. M., & Bolan, G. A. (2021) · MMWR. Recommendations and Reports · doi:10.15585/mmwr.rr7004a1 · Cited by 3,018
Wing, E. J. (2016) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2016.10.004 · Cited by 304
Immunologic Biomarkers, Morbidity, and Mortality in Treated HIV Infection
Hunt, P. W., Lee, S. A., & Siedner, M. J. (2016) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiw275 · Cited by 276
Althoff, K. N., Smit, M., Reiss, P., & Justice, A. C. (2016) · Current Opinion in HIV and AIDS · doi:10.1097/coh.0000000000000305 · Cited by 174
Trickey, A., May, M., Vehreschild, J. J., Obel, N., Gill, M. J., Crane, H. M., Boesecke, C., Samji, H., Grabar, S., Cazanave, C., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0160460 · Cited by 116
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Metadata
- Authors
- Legarth, R. A., Ahlström, M. G., Kronborg, G., Larsen, C. S., Pedersen, C., Pedersen, G., Mohey, R., Gerstoft, J., & Obel, N.
- Affiliations
- Aalborg University Hospital (DK)
- Copenhagen University Hospital (DK)
- Hvidovre Hospital (DK)
- Aarhus University Hospital (DK)
- Odense University Hospital (DK)
- Regionshospitalet Herning (DK)
- Corresponding author
- Legarth, Rebecca A.
- Ahlström, Magnus G.
- Gerstoft, Jan
- Obel, Niels
- ORCID
- Venue
- JAIDS Journal of Acquired Immune Deficiency Syndromes
- Published
- 2016-02-01
- Volume
- 71
- Issue
- 2
- Pages
- 213-218
- ISSN
- 1525-4135 (ISSN-L)
- OpenAlex
- W1555146734
- Cited by
- 121
- References
- 22
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 11 · 2023: 10 · 2022: 12 · 2021: 13 · 2020: 16 · 2019: 12 · 2018: 14 · 2017: 13 · 2016: 12
- FWCI
- 10.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAIDS Journal of Acquired Immune Deficiency Syndromes (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
- Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
- Keywords
- HIV infection, long-term mortality, older adults, age 50 and over, survival time, mortality rate ratio, antiretroviral therapy, comorbidities, AIDS-defining events, aging with HIV
- MeSH terms
- Aged, Aged, 80 and over, Cause of Death, Denmark, Female, Humans, Male, Middle Aged, Research Design, Cohort Studies, HIV Infections, Comorbidity, Proportional Hazards Models, Kaplan-Meier Estimate
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