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Big HIV clinic sees more than 1000% jump in patients 65 and older
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9th International Workshop on HIV and Aging, September 13-14, 2018, New York
Mark Mascolini
From 2000 to 2018 at the University of California, San Diego (UCSD) HIV clinic, median age jumped from 39 to 50 years, while the number of people 65 or older rose more than 1000%, from 19 to 246.
Everyone knows HIV populations are aging, and the trend seems likely to continue as clinicians and people with HIV get smarter about preventing and managing common comorbidities. But few research groups have taken the time to calculate just how old HIV groups are becoming, and how fast.
Clinicians at UCSD's Owen Clinic decided to do that by analyzing electronic records in 5 years: 2000, 2005, 2010, 2015, and 2018. Besides charting age trends, they also determined number of medications prescribed and the Veterans Aging Cohort Study (VACS) Index, which predicts all-cause mortality, cause-specific mortality, and other outcomes in people with HIV [2]. A higher VACS Index indicates a worse prognosis.
The number of HIV patients seen at the Owen Clinic jumped more than 83% across the study years, from 1771 in 2000 to 3251 in 2018. Average age vaulted from 39.8 in 2000 to 48.6 in 2018 (P < 0.00001), while median age climbed from 39 to 50 (P < 0.00001). Across the study years, the fraction of people 50 and older mushroomed from one eighth to more than one half (12.5% to 52.1%). The researchers counted 19 people 65 or older in 2000 and 246 in 2018, more than a 1000% surge. From 2000 to 2018, age trends were similar in men and women and in all races.
Median VACS index stood at 6 in people under 50, rose to 22 in those 50 to 64, and climbed to 43 in people 65 or older. People younger than 50 took a median of 6 medications, compared with 10 among people 50 to 64 and to 14 in people 65 or older. The higher VACS Index with older age, the UCSD team noted, indicates a climbing risk of adverse outcomes including death.
The UCSD investigators stressed that HIV clinicians must adapt to caring for an aging population.
References
1. Lonergan J, Mathews W, Smith D. Aging trends at a large American academic HIV clinic. 9th International Workshop on HIV and Aging, September 13-14, 2018, New York. Abstract 19.
2. Veterans Aging Cohort Study. VACS index information and VACS calculator. July 2017. https://medicine.yale.edu/intmed/vacs/welcome/vacsindexinfo.aspx
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