+

HIV in the United HIV in the United Kingdom: Kingdom: The oldest The oldest swingers?swingers?

Craig Tipple. Gary Whitlock, Collins Iwuji, Melissa Perry

+ Breaking News…

England, Wales, N. Ireland

50 yr age

New cases:Tripled: 299 (2000) 710 (2007)Of these, 48% CD4<200 (30% in <50s)

50 yr HIV+ more likely than younger to be

Men (with travel abroad)MSM WhiteUK-acquired (if heterosexual)

Increase in over-50s accessing care

+ Brighton Cohort

• 1531 patients had documented CD4 count within 3 months of diagnosis from 1st Jan 2006 to 30th May 2010

• 151/1531 (9.9%) diagnosed after the age of 50; median 54.7 (IQR 51.9-60.6)

• 753/1531(49%) of cohort presented late with HIV with median CD4 211 cells/mm3 (IQR 83-289)

• 96/151(63.6%) aged over 50 presented late with median CD4 139.5 (IQR 83-289)

• Mortality is higher in those diagnosed over age 50 compared to those under 50- OR 2.62; 95% CI: 1.64-4.20)

+ Case Summary: Mr F

70 year-old, MSM, White S. African

Diagnoses:1. Acute Cerebellar

Infarct

2. New HIV positive (CD4 190)

3. Old Anterior MI

4. Late Latent Syphilis

5. Abnormal Bone Marrow – myeloma.

+Those that survived… a personal story

“I was in my thirties when I was diagnosed, back in 1990. Then there was no therapy, no effective treatment. I didn't know how long I had, but I knew it wouldn't be long. Friends were already dead.”

“We are the generation which saw HIV transformed from a death sentence into a chronic condition. If we keep going, it's not clear what we face in older age. “

“As for the increase in the number of people my age being diagnosed for the first time with the disease, I do think it's time we got over our assumption that people that age don't have sex.”

Summary

Increase in new diagnoses in over-50s

Late presentations higher in >50s with associated higher mortality

People with HIV living longer

Need for Health Promotion work targeted at >50s and services targeted at their needs