Proposed study on HIV and ageing

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Proposed study on HIV and ageing

• As HIV mortality rates have dropped, an
  increasing proportion of individuals are living
  with HIV to older ages
• Around 15 of individuals accessing HIV care in
  England and Wales in 2007 were aged gt50 years
• There is a need to adapt the management of those
  living with HIV so that their clinical needs
  continue to be met
• However, virtually nothing is known about the
  likely health care needs of older HIV-positive
  persons

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Study objective
To create a nested, cohort of individuals aged
gt50 years, attending sites within the UK CHIC
study and Dublin HIV cohort to address questions
relating to several issues
- Uptake and outcomes of HAART in older
individuals - ARV pharmacokinetics -
Cardiovascular disease - Bone disease - CNS
complications - Musculoskeletal manifestations -
Women and the menopause - Sexual behaviour -
Social and economic factors - CMV infection in
compromising immunity during ageing - Resource
utilisation
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Proposed methods
Nested cohort study within UK CHIC and Dublin HIV
Cohort Cases HIV-positive men and women aged gt50
years from participating UK CHIC clinics/Dublin
cohort
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Proposed methods
Nested cohort study within UK CHIC and Dublin HIV
Cohort Cases HIV-positive men and women aged gt50
years from participating UK CHIC clinics/Dublin
cohort Control group 1 HIV-positive men and
women in three age groups (20-30, 30-40 and 40-50
years) attending participating clinics
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Proposed methods
Nested cohort study within UK CHIC and Dublin HIV
Cohort Cases HIV-positive men and women aged gt50
years from participating UK CHIC clinics/Dublin
cohort Control group 1 HIV-positive men and
women in three age groups (20-30, 30-40 and 40-50
years) attending participating clinics Control
group 2 Age-, sex-, ethnicity- and risk-group
matched HIV-negative persons (identified from
similar clinical settings)
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Proposed methods
Nested cohort study within UK CHIC and Dublin HIV
Cohort Cases HIV-positive men and women aged gt50
years from participating UK CHIC clinics/Dublin
cohort Control group 1 HIV-positive men and
women in three age groups (20-30, 30-40 and 40-50
years) attending participating clinics Control
group 2 Age-, sex-, ethnicity- and risk-group
matched HIV-negative persons (identified from
similar clinical settings) Fully consented study
no intervention Annual study visits Separately
funded sub-studies as necessary (e.g. in-depth
study of sexual behaviour)
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Visit schedule
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Visit schedule
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Visit schedule
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Current study team
Marta Boffito (CW) Alan Winston (St.
Marys) Jane Anderson (Homerton) Ian Williams
(MMC) Frank Post (Kings) Paddy Mallon
(Dublin) Jonathan Elford (City University,
epidemiologist) Karen Walker-Bone (Brighton) Arne
Akbar (UCL, immunologist) Caroline Sabin (UCL,
statistician/epidemiologist)
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Questions

• Is this a study that patients would be keen to
  participate in?
• If not, what might make it more attractive?
• Are there other medical issues that we should
  include?
• How do we identify suitable controls?
• Community involvement in study team?