Abstract

Research Article

Clinical and biological profiles of older adults aged 50 and over compared to those under 50 in people living with HIV attending Kinshasa University Teaching Hospital (DR Congo)

MMK Mbula*, B Longo-Mbenza, HNT Situakibanza, GL Mananga, JRR Makulo, MM Longokolo, MN Mandina, NN Mayasi, MM Mbula, B Bepouka, GL Mvumbi, EN Amaela, DN Tshilumba, O Odio, BM Ekila, A Nkodila, T Pindi and BBT Buasa

Published: 28 October, 2021 | Volume 5 - Issue 2 | Pages: 087-095

Background: The survival of people living with HIV (PLWHIVs) is increased and Health systems will have to deal with the early-aging-associated medical conditions.
Objective: The objective of this study is to compare the clinical and biological profiles of PLWHIVs aged 50 and over and those aged less than 50 years.
Material and methods: This study conducted at Kinshasa University Teaching Hospital (KUTH) covers 6 years. The clinical and biological characteristics of PLWHIVs aged 50 and over were compared with those under 50. Statistical analysis used the means ± SD, the calculation of frequencies, Student’s t-test and Chi-square.
Results: PLWHIVs aged 50 or over represented 35.1%. Their average age was 58.0 ± 4.8 years. Women predominate among those under 50 and men among those 50 and over. Married people were more numerous (54% among those under 50). There were more unemployed (50% of PLHIV under 50). Patients 50 years and older were significantly classified as WHO stage 4 with a high frequency of history of tuberculosis, genital herpes, high blood pressure, smoking, vomiting, hepatomegaly, moderate elevation of diastolic blood pressure (DBP) and sytolic blood pressure (SBP), tuberculosis and anemia.
Those under 50 had a significantly increased frequency of shingles, hepatitis B-hepatitis C, headaches and more survivals. 
The mean of Hb, HDL-C, and CD4s+ were significantly lower in patients 50 years and older, and urea, LDL-c, and ALAT levels were significantly higher. 
Conclusion: The average age was higher from 50 years old. These PLWHIVs were more frequently in WHO stage 4 with more common TB and anemia. Their Hb, HDL-C, and CD4s+ levels were lower while their urea, LDL-C and ALAT levels were significantly elevated.

Read Full Article HTML DOI: 10.29328/journal.ijcv.1001040 Cite this Article Read Full Article PDF

Keywords:

HIV/AIDS; Older adults; Elderly PLWHIVs; Clinical and biological profiles; DR Congo

References

  1. gov. Aging with HIV. PubMed: https://www.hiv.gov/hiv-basics/living-well-with-hiv/taking-care-of-yourself/aging-with-hiv .
  2. Treat all people living with HIV, offer antiretrovirals as additional prevention choice for people at "substantial" risk. PubMed: https://www.who.int/mediacentre/news/releases/2015/hiv-treat-all-recommendation/en/
  3. HIV and older Americans. PubMed: https://www.cdc.gov/hiv/group/age/olderamericans/index.html
  4. Diagnoses of HIV infection in the United States and dependent areas, 2018 (updated). HIV Surveillance Report. 2020; 31.
  5. Estimated HIV incidence and prevalence in the United States, 2014–2018. HIV Surveillance Supplemental Report. 2020; 25. http://www.cdc.gov/hiv/library/reports/hiv-surveillance.html
  6. Bhatta M, Nandi S, Dutta N, Dutta S, Saha MK. HIV Care Among Elderly Population: Systematic Review and Meta-Analysis. AIDS Res Hum Retroviruses. 2020; 36: 475-489. PubMed: https://pubmed.ncbi.nlm.nih.gov/32027170/
  7. Autenrieth CS, Beck EJ, Stelzle D, Mallouris C, Mahy, et al. Global and regional trends of people living with HIV aged 50 and over : Estimates and projections for 2000-2020. PloS ONE. 2020; 13: e0207005. PubMed: https://pubmed.ncbi.nlm.nih.gov/30496302/
  8. Negredo E, Back D, Blanco José-Ramón, Blanco J, Erlandson KM, et al. Aging in HIV-Infected Subjects: A New Scenario and a New View. BioMed Res Int. 2017; 2017: 5897298. PubMed: https://pubmed.ncbi.nlm.nih.gov/29430462/
  9. Wing EJ. HIV and aging. Int J Infect Dis. 2016; 53: 61–68. PubMed: https://pubmed.ncbi.nlm.nih.gov/27756678/
  10. Tavoschi L, Gomes Dias J, Pharris A, EU/EEA HIV Surveillance Network. New HIV dignoses among adults aged 50 years or older in 31 European countries, 3004-15: an analysis of surveillance data. Lancet HIV. 2017; 4: e514-521. PubMed: https://pubmed.ncbi.nlm.nih.gov/28967582/
  11. Seeley J. HIV diagnosis increasing in older adult in Europe. Lancet. 2017; 4: e480-e481. PubMed: https://pubmed.ncbi.nlm.nih.gov/28967581/
  12. Sok P. Older Persons with HIV in Canada. J Infect Dis Epidemiol. 2019 ; 5: 084.
  13. Haddad N, Robert A , Popovic N et al. Newly diagnosed cases of HIV in those aged 50 years and older and those less than 50: 2008–2017. Can Commun Dis Rep. 2019; 45: 283–288. PubMed: https://pubmed.ncbi.nlm.nih.gov/31755877/
  14. McMillan JM, Krentz H, John Gill M, Hogan DB. Managing HIV infection in patients older than 50 years. CMAJ 2018; 190: E1253 -1258. PubMed: https://pubmed.ncbi.nlm.nih.gov/30348740/
  15. Puhr RM, Kumarasamy N, Penh Sun L, Ng OT, Nguyen KV, et al. HIV and Aging: Demographic Change in the Asia-Pacific Region. J Acquir Immune Defic Syndr. 2017; 74: e146-e148. PubMed: https://pubmed.ncbi.nlm.nih.gov/28267699/
  16. Mills EJ, Bakanda C, Birungi J, Chan K, Ford N, et al. Life expectancy of persons receiving combination antiretroviral therapy in low-income countries: a cohort analysis from Uganda. Ann Intern Med. 2011; 155: 209–216. PubMed: https://pubmed.ncbi.nlm.nih.gov/21768555/
  17. Hontelez JA, Lurie MN, Newell ML, Bakker R, Tanser F, et al. Ageing with HIV in South Africa. AIDS. 2011; 25: 1665–1673. PubMed: https://pubmed.ncbi.nlm.nih.gov/21681056/
  18. Negin J, Gumming RG. HIV infection in older adults in sub-sahran Africa: extrapoling from existing data. Bulletin of the World Health Organization. 2010; 88: 847-853. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971515/
  19. Hontelez JAC, de Vlas SJ, Baltussen R, Newell ML, Bakker R, et al. The impact of antiretroviral treatment on the age composition of the HIV epidemic in sub-Saharan Africa. 2012; 26 (Suppl 1): S19–S30. PubMed: https://pubmed.ncbi.nlm.nih.gov/22781175/
  20. Bendavida E, Fordc N, Mills EJ. HIV and Africa’s elderly: the problems and possibilities. 2012; 26 (Suppl 1): S85–S91. PubMed: https://pubmed.ncbi.nlm.nih.gov/22781181/
  21. Mpondo BCT. HIV Infection in the Elderly: Arising challenges. J Aging Res. 2016; 2016: 2404857. PubMed: https://pubmed.ncbi.nlm.nih.gov/27595022/
  22. Mills EJ, Rammohan A, Awofso N. Ageing faster with AIDS in Africa. Lancet. 2011; 377: 1131-1133. PubMed: https://pubmed.ncbi.nlm.nih.gov/21126759/
  23. Siedner MJ. Aging, Health, and Quality of Life for Older People Living With HIV in Sub-Saharan Africa: A Review and Proposed Conceptual Framework. J Aging Health. 2019; 31: 109-138. PubMed: https://pubmed.ncbi.nlm.nih.gov/28831864/
  24. Reniers G, Blom S, Calvert C, Martin-Onraet A, Herbst AJ, et al. Trends in the burden of HIV mortality after roll-out of antiretroviral therapy in KwaZulu-Natal, South Africa: an observational community cohort study. Lancet HIV. 2017; 4: e113-e121.PubMed: https://pubmed.ncbi.nlm.nih.gov/27956187/
  25. Mandina NM, Longo Mbenza B, Renzaho A. Hypovitaminosis D, Aging, HIV Infection, HAART, and Other Cardiovascular Risk Factors in Patients from Kinshasa, DR Congo, Central Africa.
  26. People aged 50 years and older.PubMed: https://www.unaids.org/sites/default/files/media_asset/12_Peopleaged50yearsandolder.pdf
  27. Haddad N, Robert A, Weeks A, Popovic A, Siu W, et al. HIV in Canada—Surveillance Report, 2018. Can Commun Dis Rep. 2019; 45: 304–312. PubMed: https://pubmed.ncbi.nlm.nih.gov/32167090/
  28. National AIDS Trust. HIV in the UK statistics-2018. PubMed: https://www.nat.org.uk/about-hiv/hiv-statistics
  29. Eduardo E, Lamb MR, Kandula S, Howard A, Mugisha V, et al. Characteristics and Outcomes among Older HIV-Positive Adults Enrolled in HIV Programs in Four Sub-Saharan African Countries. PLoS ONE. 2014; 9: e103864. PubMed: https://pubmed.ncbi.nlm.nih.gov/25075743/
  30. Nsanzimana S, Remera E, Kanters S, Chan K, Forrest JI, et al. Life expectancy among HIV-positive patients in Rwanda: A retrospective observational cohort study. Lancet Glob Health. 2015; 3: e69-e177. PubMed: https://pubmed.ncbi.nlm.nih.gov/25701995/
  31. Taylor J, Ossei PPS, Agyeman-Duah E, Baah E, Fenteng EA, et al. Socio-Demographic Characteristics of People Living with HIV/AIDS at the Komfo Anokye Teaching Hospital, Ghana: A Five-Year Retrospective Study. Acta Sci Med Sci. 2018; 2: 42-47.
  32. Durvasula R. HIV/AIDS in Older Women: Unique Challenges, Unmet Needs. Behav Med. 2014; 40: 85–98. PubMed: https://pubmed.ncbi.nlm.nih.gov/25090361/
  33. Diallo I, Meda N, Oue´draogo S, Poda A, Hema A, et al. Profiles of Elderly People Infected with HIV and Response to Antiretroviral Treatment in Burkina Faso: A Retrospective Cohort Study. J Int Assoc Provid AIDS Care. 2017; 16: 405-411. PubMed: https://pubmed.ncbi.nlm.nih.gov/28571520/
  34. Madi D, Ramakrishnan N, Unnikrishnan B, Ramapuram J, Achappa B, et al. Clinicoepidemiological Profile of Elderly PLHIV Attending a Tertiary Care Center in South India. J Int Assoc Provid AIDS Care. 2017; 16: 620–623. PubMed: https://pubmed.ncbi.nlm.nih.gov/29187076/
  35. Dakum P, Avong YK, Odutola MK, Okuma J, Kayode GA, et al. Cohort profile: the Nigerian HIV geriatric cohort study. BMC Public Health. 2020; 20: 1797. PubMed: https://pubmed.ncbi.nlm.nih.gov/33243227/
  36. Democratic Republic of the Congo 2018 international religious freedom report. Disponible à partir de. PubMed: https://www.state.gov/wp-content/uploads/2019/05/CONGO-DEM-REP-2018-INTERNATIONAL-RELIGIOUS-FREEDOM-REPORT.pdf  
  37. Cahill S, Valadéz R. Growing older with HIV/AIDS: new public health challenges. Am J Public Health. 2013; 103: e7-e15. PubMed: https://pubmed.ncbi.nlm.nih.gov/23327276/
  38. Granich R, Akolo C, Gunneberg C, Getahun H, Williams P, et al. Prevention of Tuberculosis in People Living with HIV. CID. 2010; 50: S215-S222. PubMed: https://pubmed.ncbi.nlm.nih.gov/20397951/
  39. Harding BN, Whitney BM, Nance RM, Ruderman SA, Crane HM, et al. Anemia risk factors among people living with HIV across the United States in the current treatment era: a clinical cohort study. BMC Infect Dis. 2020; 20: 238. PubMed: https://pubmed.ncbi.nlm.nih.gov/32197585/
  40. Jaganath D, Walker AS, Ssali F, Musiime V, Kiweewa F, et al. HIV-associated anemia after 96 weeks on therapy: determinants across age ranges in Uganda and Zimbabwe. AIDS Res Hum Retroviruses. 2014; 30: 523-530. PubMed: https://pubmed.ncbi.nlm.nih.gov/24506102/
  41. Cardoso SW, Torres TS, Santini-Oliveira M, Marins LMS, Veloso VG, et al. Aging with HIV: a practical review. Braz J Infect Dis. 2013; 17: 464-479. PubMed: https://pubmed.ncbi.nlm.nih.gov/23711587/
  42. Poorolajal J, Hooshmand E, Mahjub H, Esmailnasab N, Jenabi E. Survival rate of AIDS disease and mortality in HIV-infected patients: a meta-analysis. Public Health. 2016; 139: 3-12. PubMed: https://pubmed.ncbi.nlm.nih.gov/27349729/

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More