UNRECOGNIZED HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION IN THE ELDERLY

Background: Human immunodeficiency virus (HIV) infection among the elderly has not been appreciated in the United States. This is the result of their exclusion from targeted HIV-testing programs and the perception that they were not at significant risk. Methods: To assess the extent of HIV infection among elderly patients, we retrieved excess serum samples from patients 60 years or older without a history of HIV infection who died during a 1-year period at our institution. Serum samples were tested for the presence of HIV antibodies and the charts of all those found to be infected with HIV were reviewed. Results: Thirteen (5.05%) of 257 serum samples were HIV-antibody positive. Six (6.2%) of 92 men and seven (8.9%) of 78 women between the ages of 60 and 79 years were infected with HIV. In this group there was a trend toward more women having HIV infection. The death of none of the 13 patients with HIV infection was attributable to HIV infection. Conclusions: Elderly patients from certain high HIV seroprevalence communities may be at significant risk of HIV infection. The impact of this unrecognized infection on their health, their clinical outcome, and their treatment needs further evaluation. The HIV prevention and education programs should include the elderly, and further studies of HIV seroprevalence among this population should be supported.