Posted on December 16, 2014
Source: Clinical Infectious Diseases
Keri N. Althoff, Kathleen A. McGinnis, Christina M. Wyatt, Matthew S. Freiberg, Cynthia Gilbert, Krisann K. Oursler, David Rimland, Maria C. Rodriguez-Barradas, Robert Dubrow, Lesley S. Park, Melissa Skanderson, Meredith S. Shiels, Stephen J. Gange, Kelly A. Gebo, and Amy C. Justice for the Veterans Aging Cohort Study (VACS)
Background. Although it has been shown that 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 to uninfected adults. The objective of this study was to compare the median age at, and risk of, incident diagnosis of three age-associated diseases in HIV-infected and 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 April 1, 2003 to December 31, 2010. The outcomes were validated diagnoses of myocardial infarction (MI), end-stage renal disease (ESRD), and non-AIDS-defining cancers (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, 1,135 ESRD, and 4,179 NADC incident diagnoses. Mean age at MI (adjusted mean difference: -0.11 (95% confidence interval [-0.59, 0.37] years) and NADC (adjusted mean difference: -0.10 [-0.30, 0.10] 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 [-0.86, -0.07] years). HIV-infected adults had a greater risk of all three outcomes compared to 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.
