Characteristics and outcomes of older people on antiretroviral therapy in Tlokwe Clinics, South Africa.

Mareike Rabe,Melaku A Eyassu,Huibrecht C Lion-Cachet

doi:10.4102/sajhivmed.v21i1.1066

Mareike Rabe, Melaku A Eyassu + Show 1 more

Open Access

https://doi.org/10.4102/sajhivmed.v21i1.1066

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Abstract

BackgroundSouth Africa (SA) has a large human immunodeficiency virus (HIV) epidemic but little is known of its effect on those ≥ 60 years of age viz. ‘older-persons’ living with HIV (OPLWH). Numbers in this age group are increasing and are expected to place a greater strain on existing resources.ObjectivesTo describe the demographic features and the co-morbidities of OPLWH in Tlokwe. This included an assessment of viral load (VL) suppression and the identification of associations between patient characteristics and clinical outcomes.MethodsA retrospective file review was undertaken to cover the period 01 May 2017 to 30 April 2018. Descriptive statistics were applied to demographic and clinical data and to treatment outcomes. Statistically significant associations were subjected to logistic regression analysis.ResultsOf the 191 participants, 111/191 (58.1%) were female and 167/191 (87.4%) were 60 –70 years of age. Of the participants, 154/191 (81.9%) were virally suppressed (< 400 copies/mL). Hypertension (n = 106/191, 55.5%) was the most frequently identified co-morbidity. A CD4 cell count of ≥ 350 cells/mm3 at last assessment correlated positively with VL suppression (odds ratio 2.3, confidence interval 1.05–5.02, p = 0.037).ConclusionAlthough the level of VL suppression in this cohort was high, greater effort is required to bring this in line with the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommendations viz. 90% viral suppression in PLWH by 2030. Further research is needed to define the evolving long-term needs of OPLWH and to facilitate entry into care of those currently not in care.

Highlights

The term ‘older-persons’ is defined by the United Nations (UN) as persons aged ≥ 60–65 years.[1]
The number of people living with human immunodeficiency virus (HIV) (PLWH) in South Africa (SA) – including older persons living with HIV (OPLWH) – will increase
Older men and women living with HIV need to be approached using different strategies, tailored to their specific needs

Summary

Introduction

The term ‘older-persons’ is defined by the United Nations (UN) as persons aged ≥ 60–65 years.[1]. Over the 30 years, a growth rate of 218% of older persons, that is from 32 million in 2019 to 101 million in 2050, is predicted for sub-Saharan Africa (SSA).[1] Over the same period, South Africa’s (SA) older-person population is likely to increase from 8% currently, to 10.5% in 2030, and to 15.4% in 2050.3 The drivers of this change include lower fertility rates (improved access to contraception), reduced childhood mortality and better access to healthcare for all.[4] The number of people living with human immunodeficiency virus (HIV) (PLWH) in SA – including older persons living with HIV (OPLWH) – will increase These survival gains have followed the widespread use of antiretroviral therapy (ART) and the implementation of government programmes such as Universal Test and Treat (UTT).[5] For many, HIV infection has become a chronic condition.[6]. Numbers in this age group are increasing and are expected to place a greater strain on existing resources

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