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HIV Med. 2019 Feb;20(2):121-130. doi: 10.1111/hiv.12689. Epub 2018 Nov 26.

Cardiovascular disease and diabetes in HIV-positive and HIV-negative gay and bisexual men over the age of 55 years in Australia: insights from the Australian Positive & Peers Longevity Evaluation Study.

Author information

1
The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
2
RPA Sexual Health, Sydney Local Health District, Camperdown, NSW, Australia.
3
Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
4
Monash Infectious Diseases, Monash Health and Monash University, Clayton, Vic, Australia.
5
Holdsworth House Medical Practice, Sydney, NSW, Australia.
6
Cairns Sexual Health Service, Cairns North, QLD, Australia.
7
James Cook University, Cairns, QLD, Australia.

Abstract

OBJECTIVES:

As HIV-positive people age, diagnosis and management of comorbidities associated with ageing are of increasing concern. In this study, we aimed to compare the self-reported prevalences of heart disease, stroke, thrombosis and diabetes in older Australian HIV-positive and HIV-negative gay and bisexual men (GBM).

METHODS:

We analysed data from the Australian Positive & Peers Longevity Evaluation Study (APPLES), a study of a prospectively recruited cross-sectional sample of 228 (51.1%) HIV-positive and 218 (48.9%) HIV-negative GBM, aged ≥ 55 years. Regression methods were used to assess the association of HIV status with self-reported comorbidities.

RESULTS:

Of 446 patients, 389 [200 (51.4%) HIV-positive] reported their disease history. The reported prevalence of comorbidities was higher in the HIV-positive group than in the HIV-negative group: heart disease, 19.5 versus 12.2%; stroke, 7.5 versus 4.2%; thrombosis, 10.5 versus 4.2%; and diabetes, 15.0 versus 9.0%, respectively. In adjusted analyses, HIV-positive GBM had significantly increased odds of reporting heart disease [adjusted odds ratio (aOR) 1.99; P = 0.03] and thrombosis (aOR 2.87; P = 0.01). In our analysis, HIV status was not significantly associated with either age at diagnosis of heart disease (median 53 years for HIV-positive GBM versus 55 years for HIV-negative GBM; P = 0.64) or 5-year cardiovascular disease (CVD) risk estimated using the Framingham risk score.

CONCLUSIONS:

HIV-positive GBM more commonly reported heart disease and thrombosis compared with their HIV-negative peers. These results further highlight the need to understand the impact of HIV on age-related comorbidities in GBM, to guide optimal screening and treatment strategies to reduce the risk of these comorbidities among the HIV-positive population.

KEYWORDS:

HIV ; ageing; cardiovascular disease; comorbidities; diabetes

PMID:
30474916
DOI:
10.1111/hiv.12689

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