Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals: the AGEhIV cohort study.
By J. Schouten, F. Wit, I. Stolte, N. Kootstra, M. van der Valk, S. Geerlings, M. Prins, P. Reiss. Clinical Infectious Diseases, 2014
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BACKGROUND Human immunodeficiency virus (HIV)-infected individuals may be at increased risk of age-associated noncommunicable comorbidities (AANCCs). METHODS Cross-sectional analyses of AANCC prevalence (including cardiovascular, metabolic, pulmonary, renal, bone, and malignant disease) and risk factors in a prospective cohort study of HIV type 1-infected individuals and HIV-uninfected controls, who were aged ≥45 years and comparable regarding most lifestyle and demographic factors. RESULTS HIV-infected participants (n = 540) had a significantly higher mean number of AANCCs than controls (n = 524) (1.3 [SD, 1.14] vs 1.0 [SD, 0.95]; P < .001), with significantly more HIV-infected participants having ≥1 AANCC (69.4% vs 61.8%; P = .009). Hypertension, myocardial infarction, peripheral arterial disease, and impaired renal function were significantly more prevalent among HIV-infected participants. Risk of AANCC by ordinal logistic regression was independently associated with age, smoking, positive family history for cardiovascular/metabolic disease, and higher waist-to-hip ratio, but also with HIV infection (odds ratio, 1.58 [95% confidence interval, 1.23-2.03]; P < .001). In those with HIV, longer exposure to CD4 counts <200 cells/µL, and, to a lesser extent, higher levels of high-sensitivity C-reactive protein and soluble CD14, and longer prior use of high-dose ritonavir (≥400 mg/24 hours) were each also associated with a higher risk of AANCCs. CONCLUSIONS All AANCCs were numerically more prevalent, with peripheral arterial, cardiovascular disease, and impaired renal function significantly so, among HIV-infected participants compared with HIV-uninfected controls. Besides recognized cardiovascular risk factors, HIV infection and longer time spent with severe immunodeficiency increased the risk of a higher composite AANCC burden. There was a less pronounced contribution from residual inflammation, immune activation, and prior high-dose ritonavir use.
Subfields: Emergency Medicine, Epidemiology
View Paper: https://www.semanticscholar.org/paper/d17d6f342a203df577afb3b0e902fac65b460651
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In Epidemiology
Citations in the corpus
- Multivariate Computational Analysis of Gamma Delta T Cell Inhibitory Receptor Signatures Reveals the Divergence of Healthy and ART-Suppressed HIV+ Aging (2018, background): “These conditions, sometimes referred to as serious non-AIDS events (SNAEs), afflict older HIV+ individuals more frequently than both younger counterparts [4, 6] and the uninfected elderly [6] and SNAE disease onset is reported to occur at younger ages in aviremic HIV+ individuals as compared with un”
- National Lipid Association Recommendations for Patient-Centered Management of Dyslipidemia: Part 2. (2015, background): “While it is clear that prolonged survival in HIV infection is accompanied by an increased prevalence of non-HIV related co-morbidities at all ages, it is less clear whether this increased prevalence may be attributed to the actual aging process or ‘‘accelerated aging’’.(690,691) A KaiserPermanente g”