Journal Article

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

van der Valk, Marc, Schouten, Judith, Kootstra, Neeltje A., Geerlings, Suzanne E., Prins, Maria, Reiss, Peter, Stolte, Ineke G., Wit, Ferdinand W.

2014

Overview

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.

• Publisher: Oxford University Press
• Subject: Aged / AIDS / Biological and medical sciences / Cardiovascular Diseases - epidemiology / Cohort Studies / Comorbidity / Cross-Sectional Studies / Diabetes / Female / HIV / HIV infections / HIV Infections - epidemiology / HIV/AIDS / Human viral diseases / Humans / Hypertension / Hypertension - epidemiology / Immunodeficiencies / Immunodeficiencies. Immunoglobulinopathies / Immunopathology / Infectious diseases / Male / Medical sciences / Middle Aged / Myocardial infarction / Peripheral artery disease / Predisposing factors / Prevalence / Risk Factors / Viral diseases / Viral diseases of the lymphoid tissue and the blood. Aids