@article {1741,
	title = {CD4 count at presentation for HIV care in the United States and Canada: are those over 50 years more likely to have a delayed presentation?},
	journal = {AIDS research and therapy},
	volume = {7},
	year = {2010},
	month = {2010},
	pages = {45},
	abstract = {ABSTRACT: We assessed CD4 count at initial presentation for HIV care among >=50-year-olds from 1997-2007 in 13 US and Canadian clinical cohorts and compared to <50-year-olds. 44,491 HIV-infected individuals in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) were included in our study. Trends in mean CD4 count (measured as cells/mm{\textthreesuperior}) and 95\% confidence intervals ([,]) were determined using linear regression stratified by age category and adjusted for gender, race/ethnicity, HIV transmission risk and cohort. From 1997-2007, the proportion of individuals presenting for HIV care who were >=50-years-old increased from 17\% to 27\% (p-value < 0.01). The median CD4 count among >=50 year-olds was consistently lower than younger adults. The interaction of age group and calendar year was significant (p-value <0.01) with both age groups experiencing modest annual improvements over time (< 50-year-olds: 5 [4 , 6] cells/mm3; >=50-year-olds: 7 [5 , 9] cells/mm{\textthreesuperior}), after adjusting for sex, race/ethnicity, HIV transmission risk group and cohort; however, increases in the two groups were similar after 2000. A greater proportion of older individuals had an AIDS-defining diagnosis at, or within three months prior to, first presentation for HIV care compared to younger individuals (13\% vs. 10\%, respectively). Due to the increasing proportion, consistently lower CD4 counts, and more advanced HIV disease in adults >=50-year-old at first presentation for HIV care, renewed HIV testing efforts are needed.},
	issn = {1742-6405},
	doi = {10.1111/j.1530-0277.2011.01601.x},
	author = {Althoff, Keri N and Gebo, Kelly A and Gange, Stephen J and Klein, Marina B and Brooks, John T and Hogg, Robert S and Bosch, Ronald J and Horberg, Michael A and Saag, Michael S and Kitahata, Mari M and Eron, Joseph J and Napravnik, Sonia and Rourke, Sean B and Gill, M John and Rodriguez, Benigno and Sterling, Timothy R and Deeks, Steven G and Martin, Jeffrey N and Jacobson, Lisa P and Kirk, Gregory D and Collier, Ann C and Benson, Constance A and Silverberg, Michael J and Goedert, James J and McKaig, Rosemary G and Thorne, Jennifer and Rachlis, Anita and Moore, Richard D and Justice, Amy C}
}
