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2. Strong impact of smoking on multimorbidity and cardiovascular risk among human immunodeficiency virus-infected individuals in comparison with the general population.

Author

CoLaus Cohort, Aubert, V., Barth, J., Battegay, M., Bernasconi, E., Böni, J., Bucher, H.C., Burton-Jeangros, C., Calmy, A., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Gorgievski, M., Günthard, H., Haerry, D., Hasse, B., Hirsch, H.H., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Metzner, K., Müller, N., Nadal, D., Pantaleo, G., Rauch, A., Regenass, S., Rickenbach, M., Rudin, C., Schöni-Affolter, F., Schmid, P., Schultze, D., Schüpbach, J., Speck, R., Staehelin, C., Tarr, P., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Jean-Michel, A., Murielle, B., Jean Michel, G., Christoph, H., Thomas, L., Pedro, M.V., Vincent, M., Fred, P., Martin, P., Peter, V., Roland, V.K., Aidacic, V., Gerard, W., Jürg, B., Markus, B., Heinz, B., Martin, B., Hans-Ulrich, B., Ivo, B., Reto, C., Isabelle, C., Corinne, C., Sima, D., Peter, D., Simone, E., Andrea, F., Markus, F., Claudius, F., Jakob, F., Ali, G.M., Matthias, G., Denis, H., Marcel, H., Walter, H., Simon, H., Felix, H., Paul, H., Eva, K., Vladimir, K., Daniel, K., Stephan, K., Beat, K., Benedict, K., Heidi, K., Vesna, L., Giovanni, L., Werner, L.H., Phillippe, L., Severin, L., Christoph, M., Jürgen, M., Damian, M., Werner, M., Titus, M., Valentina, N., Jakob, R., Thomas, R., Hana, S., Frank, S., Georg, S., Oliver, S., Pietro, S., Jacques, S., Alfred, S., Alois, S., Claudia, S., Othmar, S., Phuoc, T.T., Marco, V., Alessandro, V., René, V.A., Hans, W., Fritz, W., Johanna, W.S., Joseph, W., Marco, Z., Tarr, P.E., Marques-Vidal, P., Waeber, G., Preisig, M., Mooser, V., Valeri, F., Djalali, S., Andri, R., Cavassini, M., Senn, O., Vollenweider, P., FIRE, CoLaus Cohort, Aubert, V., Barth, J., Battegay, M., Bernasconi, E., Böni, J., Bucher, H.C., Burton-Jeangros, C., Calmy, A., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Gorgievski, M., Günthard, H., Haerry, D., Hasse, B., Hirsch, H.H., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Metzner, K., Müller, N., Nadal, D., Pantaleo, G., Rauch, A., Regenass, S., Rickenbach, M., Rudin, C., Schöni-Affolter, F., Schmid, P., Schultze, D., Schüpbach, J., Speck, R., Staehelin, C., Tarr, P., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Jean-Michel, A., Murielle, B., Jean Michel, G., Christoph, H., Thomas, L., Pedro, M.V., Vincent, M., Fred, P., Martin, P., Peter, V., Roland, V.K., Aidacic, V., Gerard, W., Jürg, B., Markus, B., Heinz, B., Martin, B., Hans-Ulrich, B., Ivo, B., Reto, C., Isabelle, C., Corinne, C., Sima, D., Peter, D., Simone, E., Andrea, F., Markus, F., Claudius, F., Jakob, F., Ali, G.M., Matthias, G., Denis, H., Marcel, H., Walter, H., Simon, H., Felix, H., Paul, H., Eva, K., Vladimir, K., Daniel, K., Stephan, K., Beat, K., Benedict, K., Heidi, K., Vesna, L., Giovanni, L., Werner, L.H., Phillippe, L., Severin, L., Christoph, M., Jürgen, M., Damian, M., Werner, M., Titus, M., Valentina, N., Jakob, R., Thomas, R., Hana, S., Frank, S., Georg, S., Oliver, S., Pietro, S., Jacques, S., Alfred, S., Alois, S., Claudia, S., Othmar, S., Phuoc, T.T., Marco, V., Alessandro, V., René, V.A., Hans, W., Fritz, W., Johanna, W.S., Joseph, W., Marco, Z., Tarr, P.E., Marques-Vidal, P., Waeber, G., Preisig, M., Mooser, V., Valeri, F., Djalali, S., Andri, R., Cavassini, M., Senn, O., Vollenweider, P., and FIRE

Abstract

Background. Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods. We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using Electronic Medical Records) records. The incidence of the respective endpoints were assessed among SHCS and CoLaus participants. Poisson regression models were adjusted for age, sex, body mass index, and smoking. Results. Overall, 74 291 participants contributed data to prevalence analyses (3230 HIV-infected; 71 061 controls). In CoLaus, FIRE, and SHCS, multimorbidity was present among 26%, 13%, and 27% of participants. Compared with nonsmoking individuals from CoLaus, the incidence of cardiovascular disease was elevated among smoking individuals but independent of HIV status (HIV-negative smoking: incidence rate ratio [IRR] = 1.7, 95% confidence interval [CI] = 1.2-2.5; HIV-positive smoking: IRR = 1.7, 95% CI = 1.1-2.6; HIV-positive nonsmoking: IRR = 0.79, 95% CI = 0.44-1.4). Compared with nonsmoking HIV-negative persons, multivariable Poisson regression identified associations of HIV infection with hypertension (nonsmoking: IRR = 1.9, 95% CI = 1.5-2.4; smoking: IRR = 2.0, 95% CI = 1.6-2.4), kidney (nonsmoking: IRR = 2.7, 95% CI = 1.9-3.8; smoking: IRR = 2.6, 95% CI = 1.9-3.6), and liver disease (nonsmoking: IRR = 1.8, 95% CI = 1.4-2.4; smoking: IRR = 1.7, 95% CI = 1.4-2.2). No evidence was found for an association of HIV-infection or smoking with diabetes mellitus. Conclusions. Multimorbidity is more prevalent and incident in HIV-positive compared with HIV-negative individuals. Smoking, but not HIV status, has a strong impact on cardiovascular risk and multimorbidity.

Published
2015

4. Strong Impact of Smoking on Multimorbidity and Cardiovascular Risk Among Human Immunodeficiency Virus-Infected Individuals in Comparison With the General Population

Author

Hasse, Barbara, Tarr, Philip E, Marques-Vidal, Pedro, Waeber, Gerard, Preisig, Martin, Mooser, Vincent, Valeri, Fabio, Djalali, Sima, Rauch, Andri, Bernasconi, Enos, Calmy, Alexandra, Cavassini, Matthias, Vernazza, Pietro, Battegay, Manuel, Weber, Rainer, Senn, Oliver, Vollenweider, Peter, Ledergerber, Bruno, Aubert, V, Barth, J, Battegay, M, Bernasconi, E, Böni, J, Bucher, H C, Burton-Jeangros, C, Calmy, A, Cavassini, M, Egger, M, Elzi, L, Fehr, J, Fellay, J, Furrer, Hansjakob, Fux, C A, Gorgievski, Meri, Günthard, H, Haerry, D, Hasse, B, Hirsch, H H, Hösli, I, Kahlert, C, Kaiser, L, Keiser, O, Klimkait, T, Kouyos, R, Kovari, H, Ledergerber, B, Martinetti, G, Martinez de Tejada, B, Metzner, K, Müller, N, Nadal, D, Pantaleo, G, Regenass, S, Rickenbach, M, Rudin, C, Schöni-Affolter, F, Schmid, P, Schultze, D, Schüpbach, J, Speck, R, Stähelin, Cornelia Johanna, Tarr, P, Telenti, A, Trkola, A, Vernazza, P, Weber, R, Yerly, S, Jean-Michel, Aubry, Murielle, Bochud, Jean Michel, Gaspoz, Christoph, Hock, Thomas, Lüscher, Pedro, Marques Vidal, Vincent, Mooser, Fred, Paccaud, Martin, Preisig, Peter, Vollenweider, Roland, Von Känel, Aidacic, Vladeta, Gerard, Waeber, Jürg, Beriger, Markus, Bertschi, Heinz, Bhend, Martin, Büchi, Hans-Ulrich, Bürke, Ivo, Bugmann, Reto, Cadisch, Isabelle, Charles, Corinne, Chmiel, Sima, Djalali, Peter, Duner, Simone, Erni, Andrea, Forster, Markus, Frei, Claudius, Frey, Jakob, Frey, Ali, Gibreil Musa, Matthias, Günthard, Denis, Haller, Marcel, Hanselmann, Walter, Häuptli, Simon, Heininger, Felix, Huber, Paul, Hufschmid, Eva, Kaiser, Vladimir, Kaplan, Daniel, Klaus, Stephan, Koch, Beat, Köstner, Benedict, Kuster, Heidi, Kuster, Vesna, Ladan, Giovanni, Lauffer, Werner, Leibundgut Hans, Phillippe, Luchsinger, Severin, Lüscher, Christoph, Maier, Jürgen, Martin, Damian, Meli, Werner, Messerli, Titus, Morger, Valentina, Navarro, Jakob, Rizzi, Thomas, Rosemann, Hana, Sajdl, Frank, Schindelek, Georg, Schlatter, Oliver, Senn, Pietro, Somaini, Jacques, Staeger, Alfred, Staehelin, Alois, Steinegger, Claudia, Steurer, Othmar, Suter, Phuoc, Truong The, Marco, Vecellio, Alessandro, Violi, René, Von Allmen, Hans, Waeckerlin, Fritz, Weber, Johanna, Weber-Schär, Joseph, Widler, Marco, Zoller, Burton-Jeangros, Claudine, Kaiser, Laurent, Aubry, Jean-Michel, Bochud, Murielle, Gaspoz, Jean-Michel, Frei, Markus, CoLaus Cohort, Aubert, V., Barth, J., Battegay, M., Bernasconi, E., Böni, J., Bucher, H.C., Burton-Jeangros, C., Calmy, A., Egger, M., Elzi, L., Fehr, J., Fellay, J., Furrer, H., Fux, C.A., Gorgievski, M., Günthard, H., Haerry, D., Hasse, B., Hirsch, H.H., Hösli, I., Kahlert, C., Kaiser, L., Keiser, O., Klimkait, T., Kouyos, R., Kovari, H., Ledergerber, B., Martinetti, G., Martinez de Tejada, B., Metzner, K., Müller, N., Nadal, D., Pantaleo, G., Rauch, A., Regenass, S., Rickenbach, M., Rudin, C., Schöni-Affolter, F., Schmid, P., Schultze, D., Schüpbach, J., Speck, R., Staehelin, C., Tarr, P., Telenti, A., Trkola, A., Vernazza, P., Weber, R., Yerly, S., Jean-Michel, A., Murielle, B., Jean Michel, G., Christoph, H., Thomas, L., Pedro, M.V., Vincent, M., Fred, P., Martin, P., Peter, V., Roland, V.K., Aidacic, V., Gerard, W., Jürg, B., Markus, B., Heinz, B., Martin, B., Hans-Ulrich, B., Ivo, B., Reto, C., Isabelle, C., Corinne, C., Sima, D., Peter, D., Simone, E., Andrea, F., Markus, F., Claudius, F., Jakob, F., Ali, G.M., Matthias, G., Denis, H., Marcel, H., Walter, H., Simon, H., Felix, H., Paul, H., Eva, K., Vladimir, K., Daniel, K., Stephan, K., Beat, K., Benedict, K., Heidi, K., Vesna, L., Giovanni, L., Werner, L.H., Phillippe, L., Severin, L., Christoph, M., Jürgen, M., Damian, M., Werner, M., Titus, M., Valentina, N., Jakob, R., Thomas, R., Hana, S., Frank, S., Georg, S., Oliver, S., Pietro, S., Jacques, S., Alfred, S., Alois, S., Claudia, S., Othmar, S., Phuoc, T.T., Marco, V., Alessandro, V., René, V.A., Hans, W., Fritz, W., Johanna, W.S., Joseph, W., and Marco, Z.

Subjects
medicine.medical_specialty, multimorbidity, Population, 610 Medicine & health, Rate ratio, Major Articles, ddc:616.89, 03 medical and health sciences, symbols.namesake, 0302 clinical medicine, Internal medicine, Medicine, 030212 general & internal medicine, Poisson regression, HIV-infection, education, ddc:613, ddc:616, 2. Zero hunger, 0303 health sciences, education.field_of_study, 030306 microbiology, business.industry, Incidence (epidemiology), virus diseases, medicine.disease, Comorbidity, Confidence interval, 3. Good health, comorbidity, Infectious Diseases, Oncology, Immunology, symbols, 570 Life sciences, biology, business, Body mass index, Cohort study
Abstract

AIDS-associated morbidity has diminished due to excellent viral control. Multimorbidity are more prevalent and incident in Swiss HIV-positive persons compared to HIV-negative controls. However, smoking, but not HIV status, had a strong impact on cardiovascular risk and multimorbidity., Background. Although acquired immune deficiency syndrome-associated morbidity has diminished due to excellent viral control, multimorbidity may be increasing among human immunodeficiency virus (HIV)-infected persons compared with the general population. Methods. We assessed the prevalence of comorbidities and multimorbidity in participants of the Swiss HIV Cohort Study (SHCS) compared with the population-based CoLaus study and the primary care-based FIRE (Family Medicine ICPC-Research using Electronic Medical Records) records. The incidence of the respective endpoints were assessed among SHCS and CoLaus participants. Poisson regression models were adjusted for age, sex, body mass index, and smoking. Results. Overall, 74 291 participants contributed data to prevalence analyses (3230 HIV-infected; 71 061 controls). In CoLaus, FIRE, and SHCS, multimorbidity was present among 26%, 13%, and 27% of participants. Compared with nonsmoking individuals from CoLaus, the incidence of cardiovascular disease was elevated among smoking individuals but independent of HIV status (HIV-negative smoking: incidence rate ratio [IRR] = 1.7, 95% confidence interval [CI] = 1.2–2.5; HIV-positive smoking: IRR = 1.7, 95% CI = 1.1–2.6; HIV-positive nonsmoking: IRR = 0.79, 95% CI = 0.44–1.4). Compared with nonsmoking HIV-negative persons, multivariable Poisson regression identified associations of HIV infection with hypertension (nonsmoking: IRR = 1.9, 95% CI = 1.5–2.4; smoking: IRR = 2.0, 95% CI = 1.6–2.4), kidney (nonsmoking: IRR = 2.7, 95% CI = 1.9–3.8; smoking: IRR = 2.6, 95% CI = 1.9–3.6), and liver disease (nonsmoking: IRR = 1.8, 95% CI = 1.4–2.4; smoking: IRR = 1.7, 95% CI = 1.4–2.2). No evidence was found for an association of HIV-infection or smoking with diabetes mellitus. Conclusions. Multimorbidity is more prevalent and incident in HIV-positive compared with HIV-negative individuals. Smoking, but not HIV status, has a strong impact on cardiovascular risk and multimorbidity.

Published
2015
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