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Older Women With HIV Report
"Premature Aging" Strikingly More Often Than Men
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First International Workshop on HIV and Aging, October 4-5, 2010, Baltimore
Mark Mascolini
While fewer than 20% of men infected with HIV for at least 15 years thought they were aging prematurely, 80% of women infected 15 years or more had that impression in a single-center study in Barcelona [1]. Women reported mobility, mood, and other aging-related symptoms much more often than men.
Researchers at the Germans Trias i Pujol University Hospital studied 100 people--60 men and 40 women--who had been infected with HIV for at least 15 years (average HIV duration 18.5 +/- 3.2 years). Study participants completed a questionnaire developed for this study to rate 19 aging-related symptoms for frequency, intensity, and limitation of daily living or working. Researchers also asked these 100 people for their impression of whether they were aging prematurely.
Almost all study participants had well-controlled HIV infection, and women were demographically and clinically similar to men in HIV-related characteristics. The group's age averaged 48.3 years +/- 6.05, lowest-ever CD4 count averaged 198 +/- 131, and current CD4 count averaged 573 +/- 247.5. Forty study participants (40% of men and 45% of women) had hepatitis C virus (HCV) coinfection, and 78 had an HIV load below 25 copies.
For the whole group, the most frequent symptoms were fatigue (91%), joint pain (83%), memory loss (82%), difficulty concentrating (82%), anxiety (82%), difficulty sleeping (79%), sadness (79%), loss of sexual interest (78%), and dry skin (77%). Women reported several symptoms more frequently than men:
-- Fatigue: 100% versus 85%, P = 0.04
-- Mobility difficulty: 82% versus 61%, P = 0.02
-- Hair thinning: 74% versus 48%, P = 0.01
-- Sadness: 91% versus 72%, P = 0.02
-- Anxiety: 92% versus 76%, P = 0.04
-- Difficulty sleeping, 91% versus 74%, P = 0.04
On a 5-point scale, women recorded a significantly higher average intensity of mobility difficulty (2.92 +/- 1.44 versus 2.03 +/- 1.23 in men, P = 0.04), joint pain (3.35 +/- 1.25 versus 2.80 +/- 1.25 in men, P = 0.04), postural balance difficulty (2.30 +/- 1.22 versus 1.78 +/- 0.96 in men, P = 0.02), dry skin (3.30 +/- 1.25 versus 2.65 +/- 1.41, P = 0.02), hair thinning (2.96 +/- 1.14 versus 2.04 +/- 1.39 in men, P = 0.001), sadness (3.56 +/- 1.18 versus 2.8 +/- 1.06 in men, P = 0.02), anxiety (3.34 +/- 1.20 versus 2.6 +/- 1.23 in men, P = 0.006), and loss of sexual interest (3.79 +/- 1.31 versus 2.80 +/- 1.28, P = 0.006).
Forty-three study participants believed they were aging prematurely: 80% of women and 18% of men (P < 0.001). A significantly higher proportion of women than men thought these symptoms limited their personal life (82% versus 63%, P = 0.04) or their work activity (77% versus 53%, P = 0.02).
The investigators noted that women in many cultures are more apt than men to report clinical and psychological complaints. Still, they stressed that symptom prevalence was high in both men and women infected with HIV for more than 15 years. The high HCV prevalence in this population could also contribute to the high rate of self-reported symptoms. The researchers believe their results suggest that women "could be more vulnerable to the impact of these clinical manifestations" than men.
Reference
1. Fumaz CR, Ferrer MJ, Munoz-Moreno JA, et al. Gender differences in aging associated-symptoms and their impact on quality of life in HIV-infected subjects. First International Workshop on HIV and Aging. October 4-5, 2010. Baltimore. Abstract O_13.
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