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Clin Infect Dis. 2015 Feb 15;60(4):627-38. doi: 10.1093/cid/ciu869. Epub 2014 Oct 30.

Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults.

Author information

1
Johns Hopkins University, Baltimore, Maryland.
2
Veterans Affairs Pittsburgh Healthcare System, Pennsylvania.
3
Icahn School of Medicine at Mount Sinai, New York, New York.
4
Vanderbilt School of Medicine, Nashville, Tennessee.
5
Veterans Affairs Medical Center and George Washington University Medical Center, Washington D.C.
6
Salem Veterans Affairs Medical Center, Virginia University of Maryland School of Medicine, Baltimore.
7
Atlanta Veterans Affairs Medical Center and Emory University School of Medicine, Georgia.
8
Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas.
9
Veterans Affairs Connecticut Healthcare System and Yale Schools of Medicine and Public Health, New Haven, Connecticut.
10
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.

Abstract

BACKGROUND:

Although it has been shown that human immunodeficiency virus (HIV)-infected adults are at greater risk for aging-associated events, it remains unclear as to whether these events happen at similar, or younger ages, in HIV-infected compared with uninfected adults. The objective of this study was to compare the median age at, and risk of, incident diagnosis of 3 age-associated diseases in HIV-infected and demographically similar uninfected adults.

METHODS:

The study was nested in the clinical prospective Veterans Aging Cohort Study of HIV-infected and demographically matched uninfected veterans, from 1 April 2003 to 31 December 2010. The outcomes were validated diagnoses of myocardial infarction (MI), end-stage renal disease (ESRD), and non-AIDS-defining cancer (NADC). Differences in mean age at, and risk of, diagnosis by HIV status were estimated using multivariate linear regression models and Cox proportional hazards models, respectively.

RESULTS:

A total of 98 687 (31% HIV-infected and 69% uninfected) adults contributed >450 000 person-years and 689 MI, 1135 ESRD, and 4179 NADC incident diagnoses. Mean age at MI (adjusted mean difference, -0.11; 95% confidence interval [CI], -.59 to .37 years) and NADC (adjusted mean difference, -0.10 [95% CI, -.30 to .10] years) did not differ by HIV status. HIV-infected adults were diagnosed with ESRD at an average age of 5.5 months younger than uninfected adults (adjusted mean difference, -0.46 [95% CI, -.86 to -.07] years). HIV-infected adults had a greater risk of all 3 outcomes compared with uninfected adults after accounting for important confounders.

CONCLUSIONS:

HIV-infected adults had a higher risk of these age-associated events, but they occurred at similar ages than those without HIV.

KEYWORDS:

HIV infection; aging; end-stage renal disease; myocardial infarction; non-AIDS-defining cancers

PMID:
25362204
PMCID:
PMC4318916
DOI:
10.1093/cid/ciu869
[Indexed for MEDLINE]
Free PMC Article

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