Geriatric human immune deficiency virus (HIV) Infection in Nigeria: A caseseries report

Abstract

This study involves a case‐series of 3 elderly male patients with human immune deficiency virus (HIV) infection managed between 2009 and 2010 at the antiretroviral clinic (ART) University of Ilorin Teaching Hospital, Nigeria. They were all within the age range of 73 to 100 years and had multiple sexual partners. They were also co‐managed for hypertension, diabetes mellitus and benign prostatic hyperplasia. Baseline CD4 count was < 350 cell/mm3for all of them and their chemistry and haematology results were within normal ranges. Sputum acid fast bacilli (AFB) was also negative. They all had first-line anti retroviral (ARV) therapy and cotrimoxazole prophylaxis. Initially, adherence was perfect in all of them (≥ 95%) especially as their relatives who double as the treatment‐partners ensured their regular intake of ARV and clinic attendance but later adherence became poor (< 80%) which was reflected in the fallen CD4 counts. Reasons for this include dementia and polypharmacy. One developed severe anaemia due to zidovudine (ZDV)‐induced bone marrow suppression and was appropriately managed. Two of the three cases died < 2 years post‐HIV diagnosis. Conclusively, geriatric HIV infection management entails multidisciplinary approach and a sound working knowledge of antiretroviral therapy with all the peculiar charateristics in the elderly. Key words: Human immune deficiency virus (HIV), geriatric, adherence, highly active antiretroviral therapy (HAART), people living with HIV (PLHIV).