Introduction Human Immunodeficiency Virus (HIV) infection was previously thought as a disease of the young. Clinicians are now encountering increasing numbers of older HIV patients in routine practice. Management elderly HIV can be challenging as they may present with advanced disease and they may also have multiple co-morbidities. There is a dearth of research in this field from India. The aim of our study was to determine the clinico-epidemiological profile of elderly ART naïve HIV patients attending a tertiary care institution.

Methodology This cross-sectional study was done in the ART centre attached to a tertiary care hospital of Southern India. Data of 120 patients who were diagnosed to be HIV-positive at or after age of 50 years (elderly HIV) from 2009 to 2014 was analysed after approval from the ethics committee. Sociodemographic and clinical characteristics were described using descriptive statistics.

Results Among 786 HIV patients detected from 2009 to 2014, 120 (15.27%) were elderly HIV. Majority of them 82 (68.33%) were males. The mean age of males and females was 56.12 ± 6.88 and 55.34 ± 4.23 years. Heterosexual mode was the commonest mode of acquiring HIV 74 (61.67%). Majority of them 77 (64.17%) were in WHO stage 1. Tuberculosis was seen in 32 (26.6%) The common co-morbidities seen were hypertension 93 (77.5%) and diabetes 8 (6.6%). The median CD4 count (n = 112) at presentation was 245 cells/mm³ (IQR 145–426.2). Late presenters (CD4 less than 200 cells/mm³) were 47 (41.96%).

Conclusion In our study 15% of patients attending ART centre were elderly. Majority of them had co morbidities. A significant proportion of them were late presenters. Physicians should have a high index of suspicion in diagnosing HIV in this age group as most of the symptoms of this disease may simulate the process of normal ageing. National programmes and policy makers must focus their attention on geriatric HIV.