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Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 10 Original Research

Characteristics and outcomes of older people on

antiretroviral therapy in Tlokwe Clinics, South Africa

Authors: Background: South Africa (SA) has a large human immunodeficiency virus (HIV) epidemic
1
Mareike Rabe but little is known of its effect on those ≥ 60 years of age viz. ‘older-persons’ living with HIV
Huibrecht C. Lion-Cachet 1
Melaku A. Eyassu 1 (OPLWH). Numbers in this age group are increasing and are expected to place a greater strain
on existing resources.
Affiliations:
1 Department of Family Objectives: To describe the demographic features and the co-morbidities of OPLWH in
Medicine and Primary Care, Tlokwe. This included an assessment of viral load (VL) suppression and the identification of
Faculty of Health Sciences, associations between patient characteristics and clinical outcomes.
University of the
Witwatersrand, Methods: A retrospective file review was undertaken to cover the period 01 May 2017 to 30
Johannesburg, South Africa April 2018. Descriptive statistics were applied to demographic and clinical data and to

Corresponding author: treatment outcomes. Statistically significant associations were subjected to logistic regression
Mareike Rabe, analysis.
[email protected]
̶
Results: Of the 191 participants, 111/191 (58.1%) were female and 167/191 (87.4%) were 60 70
Dates: years of age. Of the participants, 154/191 (81.9%) were virally suppressed (< 400 copies/mL).
Received: 06 Jan. 2020 Hypertension (n = 106/191, 55.5%) was the most frequently identified co-morbidity. A CD4 cell
Accepted: 28 Apr. 2020 3
Published: 07 July 2020 count of ≥ 350 cells/mm at last assessment correlated positively with VL suppression (odds
ratio 2.3, confidence interval 1.05–5.02, p = 0.037).
How to cite this article:
Rabe M, Lion-Cachet HC, Conclusion: Although the level of VL suppression in this cohort was high, greater effort is
Eyassu MA. Characteristics required to bring this in line with the Joint United Nations Programme on HIV/AIDS
and outcomes of older (UNAIDS) recommendations viz. 90% viral suppression in PLWH by 2030. Further research is
people on antiretroviral needed to define the evolving long-term needs of OPLWH and to facilitate entry into care of
therapy in Tlokwe Clinics,
South Africa. S Afr J HIV Med. those currently not in care.
2020;21(1), a1066. https://
doi.org/10.4102/sajhivmed. Keywords: HIV; older adults; characteristics; outcomes; antiretroviral therapy.
v21i1.1066

Copyright: Introduction
© 2020. The Authors.
Licensee: AOSIS. This work The term ‘older-persons’ is defined by the United Nations (UN) as persons aged ≥ 60–65 years. 1
is licensed under the This definition has been used in this study because South African citizens become eligible for an
Creative Commons ‘older-persons’ government grant at 60 years of age. Globally, the number of people in this age
2

Attribution License.
group is increasing. Over the next 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). Over the same
1
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. The drivers of this change include lower fertility rates
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(improved access to contraception), reduced childhood mortality and better access to healthcare
for all. The number of people living with human immunodeficiency virus (HIV) (PLWH) in SA –
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including older persons living with HIV (OPLWH) – will also 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). For many, HIV infection has
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become a chronic condition. 6
South African doctors are ill equipped to provide care to OPLWH, as they are not adequately
trained in gerontology and trained geriatricians in SA tend to work in academic centres. Medical
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training centres in SA do not offer sub-speciality training that combines geriatrics and HIV. The
lack of trained infectious disease specialists in the sphere of geriatric medicine may pose a
Read online: problem in future, and primary care clinicians will likely treat these patients, as they do currently.
Read online:
Scan this QR
Scan this QR The treatment and care OPLWH need is laborious and complex. The persistence of subclinical
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smart phone or inflammation even when a patient is on effective ART leads to persistent immune dysfunction.
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defining malignancy viz. the increase of co-morbid conditions. Old age increases health risks.
http://www.sajhivmed.org.za 265 Open Access