Monday, February 13 2012

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Professor Courtenay Bartholomew...

A HIGH number of persons 50 years and older are seeking treatment for the Human Immunodeficiency Virus (HIV). Local researchers have found 28.7 percent of new patients are middle- aged and senior citizens.

This was discovered in a study undertaken by the Medical Research Foundation (MRC) which analysed data for a six-year period 2004-2011 of 4,566 “new patients” enrolled for the first time in its Port-of-Spain clinic before receiving antiretroviral therapy treatment.

“As many as 1,216, 26 percent of our patients were between the ages of 50 years and 64 years— 588 males and 628 females and 128, 2.7 percent were 65 years and over, 70 males and 58 females,” the MRC said in a statement.

It compared TT’s data with studies done in the United States which found 14 percent to 15 percent of new infections were detected in persons 50 years and older and 1.5 percent in persons 65 years and older.

The MRC said 27 of its patients were 70-79 years, the group comprised 20 males and seven females. Eight patients were 80-years-old and older, six males and two females. The oldest patient was an 85-year-old male.

It said the reasons for a relatively larger percentage of new patients in these older age groups in TT versus those in the US was being further analysed for publication in a scientific journal, including the level of immune incompetence at the time of their initial visit to the clinic, their lifestyles and the reason for their late HIV detection and presentation to our centre.

The MRC provided factors which might hinder older adults from getting tested: misconceptions about HIV infection and who is infected.

It said people may not recognise that the incubation period between infection and symptoms of disease may be as long as ten years or more.

It cited a CDC study from 2005 which found that adults 65 years and older had the lowest HIV testing rates and only 11.4 percent had ever had an HIV test compared with other age groups.

“It is now clear that HIV should be considered in certain clinically suspicious older persons, even if, for example, they report being monogamous or abstinent at the time, since the incubation period from infection to signs and symptoms may be ten years or longer.” Contacted for comment yesterday, director of the MRC Professor Courtenay Bartholomew said doctors and patients may not consider testing for HIV when patients display certain physical symptoms which cannot be explained.

He said the findings in the MRC study were “surprising” to the researchers since the focus has been on the 25-49 age group as the group with the highest incidence of HIV. Bartholomew said the World Health Organisation (WHO) has recognised that fewer studies have been done on HIV and AIDS in older persons.

Drug therapy has allowed persons to live longer with HIV however, he said among new patients HIV is being seen in a number of elderly people.