Page 330 - HIVMED_v21_i1.indb

Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 5 Original Research

Profile of elderly patients receiving antiretroviral

therapy at Newlands Clinic in 2020:

A cross-sectional study

Authors: Background: People living with HIV (PLWH) face new challenges such as accelerated ageing
Cleophas Chimbetete 1 and higher rates of comorbidities including cardiovascular, renal and metabolic diseases as
Tinashe Mudzviti
1,2
Tinei Shamu they age.
1,3
Objectives: To profile the demographic and clinical characteristics of elderly patients receiving
Affiliations:
1 Newlands Clinic, Harare, HIV care at Newlands Clinic (NC), Harare, Zimbabwe, as of 01 October 2019.
Zimbabwe
Methods: A cross-sectional analysis was conducted using clinic data. All patients who were
2 School of Pharmacy, College 50 years and older on 01 October 2019 were enrolled. Descriptive statistics (medians,
of Health Sciences, University interquartile ranges [IQRs] and proportions) were used to describe patient demographic and
of Zimbabwe, Harare, clinical characteristics.
Zimbabwe
Results: Out of 6543 patients undergoing care at NC, 1688 (25.8%) were older than 50 years.
3 Institute of Social and The median duration of antiretroviral therapy (ART) was 10.9 years (IQR: 7.1–13). Over 90%
Preventive Medicine, of all patients had an HIV viral load below 50 copies/mL. Women were more likely than men
University of Bern, Bern, to be overweight and obese (32% and 25% vs. 18% and 7%, respectively). Hypertension
Switzerland
(41.2%), arthritis (19.9%) and chronic kidney disease (11.6%) were common comorbidities
Corresponding author: differently distributed based on sex. The most common malignancy diagnosed in women was
Cleophas Chimbetete, cervical intra-epithelial neoplasia (68% of cancer burden in women) and Kaposi sarcoma was
[email protected]
the leading malignancy in men (41% of cancer burden in men). Nearly 20% of patients had at
Dates: least two chronic non-communicable comorbidities and 5.6% had at least three.
Received: 28 Aug. 2020
Accepted: 19 Sept. 2020 Conclusion: A high burden of comorbidities was observed amongst HIV-positive elderly
Published: 10 Dec. 2020 patients receiving ART. Age-appropriate monitoring protocols must be developed to ensure
optimum quality of care for elderly HIV-positive individuals.
How to cite this article:
Chimbetete C, Mudzviti T, Keywords: HIV infection; elderly patients; comorbidities; ART; Zimbabwe.
Shamu T. Profile of elderly
patients receiving
antiretroviral therapy at
Newlands Clinic in 2020: A Introduction
cross-sectional study. S Afr J
HIV Med. 2020;21(1), a1164. Effective antiretroviral therapy (ART) has changed the course of human immunodeficiency virus
https://doi.org/10.4102/ (HIV) infection from being considered a fatal illness to a chronic manageable condition. This has
sajhivmed.v21i1.1164 enabled people to grow old living with HIV. The number of people who are more than 50 years
old and living with HIV has increased globally because of the success of national ART programmes
Copyright: 1
© 2020. The Authors. and the control of new infections amongst the elderly. The life expectancy of people living with
Licensee: AOSIS. This work HIV (PLWH) has increased substantially, approximating that of the general population in high-
is licensed under the income countries. Similar gains in life expectancy have also been reported in some countries in
2,3
Creative Commons sub-Saharan Africa. It seems likely that the median age of PLWH will increase with time as more
4
Attribution License.
and more people garner the survival benefits of effective ART. It is now critical to promote healthy
ageing amongst PLWH, an achievement that some have described as the ‘fourth 90%’. 5
As PLWH age, they face many of the same health challenges as faced by older individuals in the
general population. Additionally, ageing PLWH face new challenges such as accelerated ageing and
higher rates of comorbidities including cardiovascular, renal and metabolic diseases. Comorbidities
6
occur at high rates at all ages amongst PLWH but become increasingly important as this population
ages. People living with HIV also develop geriatric syndromes and frailty earlier as compared to
Read online: HIV uninfected people. Certain ART drugs such as protease inhibitors may increase cardiovascular
7
Read online:
Scan this QR risk because of poor metabolic profile including hyperlipidaemia compared to other drugs such as
Scan this QR
code with your 8
code with your
smart phone or
smart phone or the non-nucleoside reverse transcriptase inhibitors. There has been a documented increase in the
mobile device
mobile device rate of all cancers, particularly lung, prostate, colorectal, anal, cervix, lymphomas and breast as
to read online.
to read online.
9
PLWH age. However, it is important to note that cancer rates increase with age in everyone.
http://www.sajhivmed.org.za 322 Open Access