AIDS warning: HIV infections in older people have risen sharply again

Every sixth HIV diagnosis affects people over the age of 50
According to a recent study, the number of HIV diagnoses in Europe has risen significantly among people over the age of 50. According to researchers at the European Center for Disease Prevention and Control (ECDC), every sixth new diagnosis affects people in this age group. Overall, the HIV epidemic remains a major public health problem with around 30,000 newly diagnosed infections each year in the 31 countries of the European Union and the European Economic Area.

The current study shows that the rate of newly reported HIV cases in Europe remained constant between 2004 and 2015 among the younger people, but it was an annual increase of around two percent for the older people. "The study results indicate that the HIV epidemic is developing in new directions, which may be a result of low awareness of the disease," the ECDC said. The study was published in the specialist magazine "The Lancet HIV".

More than 300,000 HIV diagnoses evaluated
For the current study, all HIV diagnoses reported to the ECDC from 2004 to 2015 were evaluated. According to this, a total of 312,501 new HIV diagnoses were found in younger adults (15 to 49 years) in the EU and the European Economic Area, which corresponds to an average of 11.4 diagnoses per 100,000 inhabitants. In addition, there were 54,102 new HIV diagnoses in adults over the age of 50 in the twelve years of the study period (2.6 diagnoses per 100,000 inhabitants).

17 percent of new diagnoses concern older people
According to the scientists, the number of new diagnoses has increased significantly among older people. Since 2004 (3,132 HIV diagnoses in people over 50 years of age), the rate of new diagnoses in this age group has increased by two percent per year, and in 2015 there were 5,076 reported infections in people over 50 years of age, a share of 17 percent corresponded to the new diagnosis. "The increase in new HIV diagnoses in older adults indicates the imperative to raise awareness among health care providers for this age group and to enable more targeted prevention measures for the entire adult population," emphasize the study authors.

Diagnosis is often delayed
The study results also show that heterosexual transmission is the main route of infection in older HIV-infected people, while homosexual men in particular are infected in younger adults. In addition, the disease is often diagnosed very late in the elderly, which causes considerable difficulties in treatment, the scientists report. With timely diagnosis and appropriate early treatment, most infected people could lead an almost normal life, but if the damage to the immune system has already progressed, the disease often results in premature death.

Improve access to HIV tests
In the older adults, 63 percent of the cases were diagnosed late, according to the scientists, whereby this was determined based on the number of so-called CD4 cells. With a value of less than 350 cells per microliter of blood there is talk of a late diagnosis, with less than 200 CD4 cells per microliter there is an advanced HIV disease. Looking at all age groups, 53 percent of infections were identified early according to this definition. For older people, however, apparently there is a problem with access to HIV tests and advice in many countries, the researchers explain.

Actively offer tests
A key factor in the early diagnosis of HIV infection among older adults, according to the researchers, is "the active offer of an HIV test by health care providers", which offer can be linked to specific health conditions. This is "a very effective and promising approach" to reach older adults as well. In addition, offering a self-test could be a valuable addition and could also help normalize HIV testing in older people and the adult population as a whole.

Raising awareness among the medical profession
Last but not least, "the medical profession needs to be made aware of the issue, even in rural areas," said RKI epidemiologist Barbara Gunsenheimer-Bartmeyer, CO author of the study, in a contribution from the news portal "WeltN24". For example, an HIV test should also be carried out if there are non-specific symptoms such as an increased susceptibility to infection or weight loss. Overall, the range of tests for older adults in particular needs to be significantly improved, the researchers conclude.

According to the scientists, an increasing number of new HIV diagnoses could be observed not only in people over the age of 50, but also in homosexual men and drug users who inject the substances into their bodies by injection. (fp)

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