Cross-sectional Comparison of the Prevalence of Age-Associated Comorbidities and Their Risk Factors Between HIV-Infected and Uninfected Individuals: The AGEhIV Cohort Study

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ID: 307213
2014
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Abstract
Human immunodeficiency virus (HIV)-infected individuals may be at increased risk of age-associated noncommunicable comorbidities (AANCCs).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.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.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.
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Authors J. Schouten, Ferdinand W.n.m. Wit, Ineke G. Stolte, Neeltje A. Kootstra, Marc van der Valk, Suzanne E. Geerlings, Maria Prins, Peter Reiss, Katherine W. Kooij, Rosan A van Zoest, B C Elsenga, Marieke Martens, Solange Moll, Jantien van Berkel, Lars Møller, Gerben-Rienk Visser, Cris M. Welling, S Zaheri, M Hillebregt, Luuk Gras, Y M C Ruijs, D P Benschop, A M Harskamp-Holwerda, Irma Maurer, M. M. Mangas Ruiz, A F Girigorie, Elisabeth van Leeuwen, F R Janssen, M. Heidenrijk, J. H. N. Schrijver, W Zikkenheiner, M. Wezel, C. S. M. Jansen-Kok, Mieke H. Godfried, Abraham Goorhuis, Jan T. M. van der Meer, F.j.b. Nellen, Tom van der Poll, Jan M. Prins, W. Joost Wiersinga, J. van Eden, A. Henderiks, A M H van Hes, M Mutschelknauss, H. Nobel, F J J Pijnappel, Anne Marie Westerman, J. de Jong, Pieter G. Postema, Peter H. Bisschop, M. J. M. Serlie, Paul Lips, E. Dekker, Sophia E. J. A. de Rooij, J M R Willemsen, Liffert Vogt, Peter Portegies, Ben Schmand, Gert J. Geurtsen, Jacqueline A. ter Stege, M. Klein Twennaar, Berthe L.F. van Eck‐Smit, Menno D. de Jong, D. J. Richel, Frank D. Verbraak, Nazli Demirkaya, I. Visser, Henricus G. Ruhé, Pythia T. Nieuwkerk, Reindert P. van Steenwijk, Erica Dijkers, Charles B.l.m. Majoie, Matthan W.A. Caan, Tanja Su, H.W. van Lunsen, M A F Nievaard, Bert‐Jan H. van den Born, Erik S.G. Stroes, W. Mulder
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Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2014
DOI
10.1093/cid/ciu701
URL
https://academic.oup.com/cid/article-pdf/59/12/1787/9415237/ciu701.pdf
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