Older HIV Patients More Likely to Adhere to HAART
Adherence may compensate for early blunted T-cell response in older patients
WEDNESDAY, April 11 (HealthDay News) -- HIV-infected patients over age 50 tend to adhere more closely to highly active antiretroviral therapy (HAART) than younger patients, and subsequently show good early responses to treatment, according to the results of a study published in the April 9 issue of the Archives of Internal Medicine. However, they are also at greater risk of adverse events than younger patients.
Michael J. Silverberg, Ph.D., M.P.H., of Kaiser Permanente in Oakland, Calif., and colleagues monitored changes in HIV clinical markers in patients in three different age groups after they initiated HAART. Patients aged 40 to 49 years or 50 years and older were compared to a reference group of 18 to 39 years.
Initially, the investigators found that the 50 year and older group achieved the best response rate to HAART, measured by HIV RNA levels. However, response rates were similar after adjusting for adherence. Older patients had blunted T-cell responses early in treatment compared with younger patients but rebounded in later years. Adverse events including metabolic, hematologic and renal abnormalities were more likely in older patients.
"The added importance of high adherence in older patients with regard to HAART response, coupled with a high first-year incidence of metabolic, hematologic and renal abnormalities, indicates that close monitoring and potential treatment modifications may be needed in patients 50 years or older," the authors write.