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July 16, 2008
Age Affects Response to Antiretroviral Therapy
Though older adults are more likely to reach an undetectable viral load from taking antiretroviral (ARV) therapy than their younger counterparts, people age 60 and older have less robust increases in CD4 counts, say the authors of a study published in the July 31 issue of AIDS.
Some studies have hinted that adults who start ARV therapy at an older age may not recover CD4 cells as well as people who start at a younger age. However, the overwhelming majority of HIV treatment studies involved younger adults, usually between the ages of 18 and 50. Moreover, few studies have compared responses to ARV therapy between children and adults of varying ages.
To more fully evaluate how age affects ARV therapy, researchers from the Observational HIV Epidemiological Research Europe (COHERE) study group collected and analyzed the medical records of 49,921 HIV-positive patients from 30 European countries who started ARV therapy between 1998 and 2006. The patients’ ages at the time they started ARV treatment ranged from infancy to more than 80 years old. The researchers separated the patients into 10 groups based on age ranges.
The COHERE researchers found that the likelihood of achieving an undetectable viral load following ARV initiation was lower in children who started treatment between the ages of 6 and 17 years old. Virologic success was greatest, however, in people who were 50 and older. Conversely, children and younger adults had the greatest gains in CD4 cells, while adults 60 and older had the slightest gains. Adults 55 and older were also less likely to recover their clinical health.
