The continued ageing of people with AIDS in Italy: recent trend from the national AIDS Registry

Abstract

Introduction. In industrialized countries, the availability of highly active antiretroviral  therapy (HAART) caused a slow but substantial ageing of the AIDS epidemic mainly  due to the longer survival of persons with HIV/AIDS which has turned HIV into a manageable, chronic disease. The number of older people with AIDS is growing in many  European countries.
We described the impact of AIDS among persons aged 50 years or more in Italy and  compared the characteristics of these cases with those of persons diagnosed with AIDS  at an age younger than 50.
Methods. The source of data was the Italian AIDS Registry, from 1982 to 2011. We  defined “older” persons those aged 50 years or more, and younger individuals those aged  less  than  50  years.  We  built  two  multivariate  logistic  regression  models:  the  first  one  to identify factors associated with being older, and the second one to identify AIDS-defining diseases correlated with being older. Variables with a P value of < 0.05 were  entered in the model.
Results. Of the total AIDS cases, 10.5% were among persons older than 49 years. This  proportion progressively increased from 0.0% in 1983 to 26.4% in 2011. Among older  cases, the incidence of AIDS was 2.0 per 100 000 residents in 1996, then decreased  to 1.4 per 100 000 in 2000 and levelled off around 1 per 100 000 residents until 2011.  Compared to younger cases, older cases were more frequently males, Italians, diagnosed  with AIDS in recent years, residing in Northern or Central Italy, non-injecting drug users, and late testers. Discussion. These findings stress the need for physicians to consider carefully the possibility of HIV infection among older individuals not to miss the opportunity to deliver  prevention messages, offer HIV testing, and make an early diagnosis.