To get a better sense of HIV infections among older patients, Dr. Justice and her colleagues in VACS (the Veterans Aging Cohort Study) asked if delays in diagnosis persisted, whether non-AIDS conditions differed from conditions seen in HIV uninfected persons of the same age, and whether selected age-associated non-AIDS conditions should be triggers for HIV testing.
They reviewed data on persons diagnosed with HIV from 2010 through 2015 within the Veterans healthcare system. They defined incidence HIV as detectable HIV-1 RNA prior to antiretroviral therapy, and matched infected to uninfected individuals by age, race, sex, site, and year.
They used diagnostic codes within 1 year before or 6 months after HIV diagnosis for data on AIDS-defining illnesses, bacterial pneumonia, and herpes zoster, and laboratory data within 6 months of diagnosis for CD4 counts, HIV-1 RNA, hemoglobin, platelet, and lymphocyte count.
In addition, the investigators drew on the Centers for Disease Control and Prevention HIV Surveillance Report for data on HIV prevalence among different age groups, and chart reviews from the Nathan Smith Clinic at Yale New Haven Hospital for clinical information.