INCREASING AGE IS ASSOCIATED WITH FASTER PROGRESSION TO NEOPLASMS BUTNOT OPPORTUNISTIC INFECTIONS IN HIV-INFECTED HOMOSEXUAL MEN

Objective: To characterize the associations of age and progression rat es to AIDS-defining neoplasms and opportunistic infections (OI) in HIV -infected homosexual men. Methods: Data from 407 homosexual men with d ocumented dates of HIV seroconversion participating in cohort studies from four geographic locations were merged. Kaplan-Meier and Cox propo rtional hazards analyses were conducted with respect to the associatio n of age with time from seroconversion to the first AIDS-defining neop lasm and OI. Results: Among the 307 participants, 139 (34%) were diagn osed with AIDS; 45 (11%) with neoplasms and 90 (22%) with OI. Older ag e at seroconversion was significantly associated with faster progressi on to neoplasms, but not to OI. For each 10-year increase in age the r isk for neoplasms increased 1.65-fold [95% confidence interval (CI), 1 .12-2.43], after adjustment for clinical treatments. For OI this risk estimate was 0.98 (95% CI, 0.72-1.34). Conclusions: Increasing age is associated with faster progression to AIDS-defining neoplasms, but not with progression to OI. This has not been previously reported and may explain conflicting results in other studies among homosexual men tha t considered AIDS as a single entity. Our findings suggest that age an d AIDS manifestations should be considered, particularly in the contex t of natural history studies, clinical trials and mathematical modelli ng.