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Premature age-related comorbidities among HIV-infected persons compared with the general population.
- Source :
-
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2011 Dec; Vol. 53 (11), pp. 1120-6. Date of Electronic Publication: 2011 Oct 13. - Publication Year :
- 2011
-
Abstract
- Background: Human immunodeficiency virus (HIV)-infected patients may have a greater risk of noninfectious comorbidities (NICMs) compared with the general population. We assessed the prevalence and risk factors for NICMs in a large cohort of HIV-infected adults and compared these findings with data from matched control subjects.<br />Methods: We performed a case-control study involving antiretroviral therapy (ART)-experienced HIV-infected patients treated at Modena University, Italy, from 2002 through 2009. These patients were compared with age-, sex-, and race-matched adults (control subjects) from the general population included in the CINECA ARNO database. NICMs included cardiovascular disease, hypertension, diabetes mellitus, bone fractures, and renal failure. Polypathology (Pp) was defined as the concurrent presence of ≥2 NICMs. Logistic regression models were constructed to evaluate associated predictors of NICMs and Pp.<br />Results: There were 2854 patients and 8562 control subjects. The mean age was 46 years, and 37% were women. Individual NICM and Pp prevalences in each age stratum were higher among patients than among controls (all P <.001). Pp prevalence among patients aged 41-50 years was similar to that among controls aged 51-60 years (P value was not statistically significant); diabetes mellitus, cardiovascular disease, bone fractures, and renal failure were statistically independent after adjustment for sex, age, and hypertension. Logistic regression models showed that independent predictors of Pp in the overall cohort were (all P < .001) age (odds ratio [OR], 1.11), male sex (OR, 1.77), nadir CD4 cell count <200 cells/μL (OR, 4.46), and ART exposure (OR, 1.01).<br />Conclusions: Specific age-related NICMs and Pp were more common among HIV-infected patients than in the general population. The prevalence of Pp in HIV-infected persons anticipated Pp prevalence observed in the general population among persons who were 10 years older, and HIV-specific cofactors (lower nadir CD4 cell count and more prolonged ART exposure) were identified as risk factors. These data support the need for earlier screening for NICMs in HIV-infected patients.
- Subjects :
- Adult
Age Factors
Anti-HIV Agents administration & dosage
Antiretroviral Therapy, Highly Active
Cardiovascular Diseases epidemiology
Case-Control Studies
Comorbidity
Diabetes Mellitus epidemiology
Female
Fractures, Bone epidemiology
HIV Infections drug therapy
Humans
Hypertension epidemiology
Italy epidemiology
Male
Middle Aged
Prevalence
Renal Insufficiency epidemiology
Risk Factors
HIV Infections complications
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6591
- Volume :
- 53
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publication Type :
- Academic Journal
- Accession number :
- 21998278
- Full Text :
- https://doi.org/10.1093/cid/cir627