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From 1990 through 2001, the number of AIDS cases in the U.S. quintupled among people age 50 or older (J Acquir Immune Defic Syndr 2003; 33:S68). Although older patients are reported to have better rates of adherence to antiretroviral therapy (ART) than do younger patients, this benefit may be counterbalanced by higher risks for medication toxicities, comorbidities, drug–drug interactions, and waning immune function. To evaluate this risk-benefit equation in more detail, investigators reviewed data from more than 5000 HIV-infected members of Kaiser Permanente Northern California and compared outcomes according to age at ART initiation (categorized as 18–39, 40–49, and ≥50). Follow-up was from 1995 through 2004.
As expected, adherence to ART (…