INFLUENCE OF AGE ON RATES OF NEW AIDS-DEFINING DISEASES AND SURVIVAL IN 6546 AIDS PATIENTS

It has consistently been reported that older AIDS patients have a shor tened survival compared with younger patients. The aim of the present study was to investigate whether this difference in survival is caused by differences in the pattern of the complicating diseases. Informati on on patient follow-up after the AIDS diagnosis was obtained by retro spective case note review. The 6,546 patients were followed from the t ime of AIDS diagnosis as part of the multicentre AIDS in Europe study, which examined AIDS cases diagnosed at 52 centres in 17 European coun tries between 1979 and 1989. Occurrence of AIDS-defining events and de mographic variables were recorded for all patients, and CD? lymphocyte count at the time of AIDS diagnosis for approximately half the patien ts. After adjusting for imbalances in other variables, persons greater than or equal to 50 years of age had a significantly higher risk of c ontracting AIDS wasting syndrome, AIDS dementia complex and oesophagea l candidiasis after the initial AIDS diagnosis, compared with age grou p 30-39 years [relative risk (RR) 95% confidence interval (CI)], 3.23 (2.70-3.75 CI); 2.48 (2.16-2.80 CI); 1.55 (1.26-1.83 CI), respectively ]. Shortened survival after the time of AIDS diagnosis was associated with older age. After adjusting for pattern of complicating diseases, the age effect remained unchanged. Older age predisposes to AIDS-relat ed wasting syndrome, AIDS dementia complex and oesophageal candidiasis . Independent of these differences, older age is significantly associa ted with shortened survival, suggesting that factors such as severity of complicating diseases or the capability of handling serious infecti ons, rather than disease pattern, are responsible for the shortened su rvival.