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Age-associated comorbidities more prevalent among people with HIV
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Researchers from the Academic Medical Center in Amsterdam have found that age-associated, noncommunicable comorbidities were more prevalent among people with HIV compared with uninfected controls.
The higher prevalence was significant for peripheral arterial disease, cardiovascular disease and impaired renal function, according to the report in Clinical Infectious Diseases.
“The trend toward a stronger association between age and age-associated, noncommunicable comorbidities burden among HIV-infected participants might support the hypothesis of premature or accelerated aging in HIV,” the researchers wrote. “Whether this reflects HIV acting as an additive risk factor for comorbidity development in conjunction with traditional risk factors, or includes HIV impacting on and accelerating the biology of aging itself, remains to be elucidated.”
The researchers conducted cross-sectional analyses of the prevalence of comorbidities and risk factors among a prospective cohort of patients with HIV and uninfected controls aged at least 45 years. At baseline and every 2 years after, the participants underwent screening for age-associated comorbidities, including cardiovascular, metabolic, pulmonary, renal, bone and malignant disease.
The cohort included 540 patients with HIV and 524 uninfected individuals who completed a baseline visit from October 2010 to September 2012. Patients with HIV had a higher mean number of comorbidities compared with uninfected controls: 1.3 vs. 1. Each individual comorbidity was more prevalent in patients with HIV. The difference in prevalence was significant for hypertension (45.4% vs. 30.5%), myocardial infarction (3.9% vs. 1.5%), peripheral arterial disease (2.6% vs. 0.6%) and impaired renal function (4.3% vs. 2.1%).
In a multivariable analysis, HIV infection was independently associated with a higher number of comorbidities (OR=1.58; 95% CI, 1.23-2.03). Other independent variables included age, positive family history and smoking. In a multivariable analysis of only the patients with HIV, longer duration of CD4 count less than 200 cells/mcL was an independent risk factor for comorbidities.
“Our findings add robustness to the notion that age-associated noncommunicable comorbidities indeed are more prevalent among those living with HIV, including those with a sustained response to antiretroviral treatment,” the researchers wrote. “Unravelling underlying mechanisms and risk factors for this increased comorbidity burden among HIV-positives is the subject of ongoing research.”
Disclosure: Some researchers report financial relationships with AbbVie, Boehringer-Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen-Cilag, Merck & Co., and ViiV Healthcare.
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