Yale University

Differences in symptom expression in older HIV-positive patients: The Veterans Aging Cohort 3 Site Study and HIV Cost and Service Utilization Study experience.

TitleDifferences in symptom expression in older HIV-positive patients: The Veterans Aging Cohort 3 Site Study and HIV Cost and Service Utilization Study experience.
Publication TypeJournal Article
Year of Publication2003
AuthorsZingmond, David S., Amy M. Kilbourne, Amy C. Justice, Neil S. Wenger, Maria Rodriguez-Barradas, Linda Rabeneck, Dennis Taub, Sharon Weissman, Janet Briggs, Joseph Wagner, Susan Smola, and Samuel A. Bozzette
JournalJournal of acquired immune deficiency syndromes (1999)
Volume33 Suppl 2
PaginationS84-92
Date Published2003 Jun 1
ISSN1525-4135
KeywordsAdult, Age Factors, Aged, Cohort Studies, Demography, Female, HIV Seropositivity, Humans, Income, Insurance, Health, Interviews as Topic, Male, Middle Aged, Risk-Taking, United States, Veterans
AbstractSymptom recognition is critical for patient care but has been little studied in older HIV-infected individuals. The authors examined differences in symptom expression between younger (younger than age 50 years) and older (older than age 50 years) HIV-infected individuals. The authors analyzed data from two cross-sectional studies of HIV-infected individuals: 2864 individuals from the HIV Cost and Service Utilization Study (HCSUS) and 881 individuals from the Veterans Aging Cohort 3 Site Study (VACS 3). The authors compared the prevalence of eight symptoms common to both studies and 10 symptoms examined only in the VACS 3 population, stratified by age and race. Disease severity was assessed by CD4 count and 18 HIV-related diseases reported. Multivariate logistic regression models were used to account for demographics and severity differences. VACS 3 versus HCSUS participants were more likely nonwhite and older. In unadjusted comparisons, older nonwhites were less likely to report experiencing symptoms than younger whites. They reported the fewest total number of symptoms and the fewest individual symptoms common to both studies (headache, fever, nausea/vomiting, and diarrhea) or in the VACS 3 only (dizziness, sleeping difficulty, fatigue, rashes, bloating, and myalgias/arthalgias). Multivariate regression estimates suggest older age predicts a greater likelihood of reporting peripheral neuropathy, weight loss, or hair loss, but a lower likelihood of reporting headaches, depressed mood, white oral patches, or diarrhea. Nonwhites appeared less likely to report symptoms. Age is a determinant of reporting certain symptoms in HIV disease but may be masked or accentuated by other factors such as race.
Alternate JournalJ. Acquir. Immune Defic. Syndr.

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