{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:47:50Z","timestamp":1789440470704,"version":"build-2803163510"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR #02684"],"award-info":[{"award-number":["CIHR #02684"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR #134047"],"award-info":[{"award-number":["CIHR #134047"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR #136882"],"award-info":[{"award-number":["CIHR #136882"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CIHR #143342"],"award-info":[{"award-number":["CIHR #143342"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002879","name":"Canadian HIV Trials Network, Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["CTN #242"],"award-info":[{"award-number":["CTN #242"]}],"id":[{"id":"10.13039\/501100002879","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to assess the adequacy of immunological recovery and virological suppression in response to antiretroviral therapy (ART) in the growing population of older people living with HIV (PLWH), as treatment regimens become more effective and tolerable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An interprovincial Canadian cohort of treatment\u2010na\u00efve PLWH who initiated ART after 1 January 2000 was used and age assessed in decades. Longitudinal absolute CD4 count response to treatment was modelled using generalized estimating equations. Cumulative incidence functions and proportional hazards models with a competing risk of death were used to estimate time to: (1) CD4\u00a0\u2265\u00a0200 cells\/\u00b5L, (2) CD4\u00a0\u2265\u00a0500 cells\/\u00b5L, (3) virological suppression (\u2264\u00a050 copies\/mL), and (4) virological failure (&gt;\u00a0200 copies\/mL).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 12\u00a0489 individuals starting ART between 2000 and 2016 with one or more post\u2010treatment CD4 count or viral load were included in the analysis. Age &gt;\u00a060 years was associated with lower absolute CD4 recovery (adjusted \u03b2\u00a0=\u00a0\u221231 cells\/\u00b5L) compared with age \u2264\u00a030 years when pre\u2010treatment CD4 count and other covariates were accounted for. Older age groups were less likely to achieve a CD4\u00a0\u2265\u00a0500 cells\/\u00b5L, with the greatest effect in the &gt;\u00a060 group [adjusted hazard ratio (aHR)\u00a0=\u00a00.69, 95% confidence interval (CI): 0.57\u20130.84 <jats:italic>vs<\/jats:italic>. age \u2264\u00a030). Older age groups were more likely to achieve viral suppression (age &gt;\u00a060, aHR\u00a0=\u00a01.20, 95% CI: 1.05\u20131.37) and less likely to have virological failure (age &gt;\u00a060, aHR\u00a0=\u00a00.46, 95% CI: 0.3\u20130.71) compared with those aged \u2264\u00a030 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Older adults have robust virological responses to ART; however, individuals over the age 60 are more likely to experience blunted CD4 recovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.13125","type":"journal-article","created":{"date-parts":[[2021,6,2]],"date-time":"2021-06-02T07:07:06Z","timestamp":1622617626000},"page":"759-769","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Immunological and virological response to initial antiretroviral therapy among older people living with HIV in the Canadian Observational Cohort (CANOC)"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-0677","authenticated-orcid":false,"given":"A","family":"Zhabokritsky","sequence":"first","affiliation":[{"name":"Department of Medicine University Health Network Toronto ON Canada"},{"name":"Department of Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Szadkowski","sequence":"additional","affiliation":[{"name":"Department of Medicine University Health Network Toronto ON Canada"},{"name":"Biostatistics Research Unit University Health Network Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AN","family":"Burchell","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine and Centre for Research on Inner City Health Li Ka Shing Knowledge Institute St. Michael\u2019s Hospital Unity Health Toronto ON Canada"},{"name":"Department of Family and Community Medicine Faculty of Medicine University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Ottawa Ottawa ON Canada"},{"name":"Clinical Epidemiology Program The Ottawa Hospital Research Institute Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RS","family":"Hogg","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Hull","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DV","family":"Kelly","sequence":"additional","affiliation":[{"name":"School of Pharmacy Memorial University St. John's Newfoundland and Labrador Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Klein","sequence":"additional","affiliation":[{"name":"McGill University Health Center Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Loutfy","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Toronto Toronto ON Canada"},{"name":"Women\u2019s College Research Institute Women\u2019s College Hospital Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"McClean","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Montaner","sequence":"additional","affiliation":[{"name":"British Columbia Centre for Excellence in HIV\/AIDS Vancouver BC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"SL","family":"Walmsley","sequence":"additional","affiliation":[{"name":"Department of Medicine University Health Network Toronto ON Canada"},{"name":"Department of Medicine University of Toronto Toronto ON Canada"},{"name":"Toronto General Hospital Research Institute University Health Network Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Canadian Observational Cohort (CANOC) Collaboration","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0207005"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v44i12a03"},{"key":"e_1_2_7_4_1","unstructured":"Centers for Disease Control and Prevention.HIV Surveillance Report 2018 (Updated); vol. 31. 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