Evolution of comorbidities in people living with HIV between 2004 and 2014: cross-sectional analyses from ANRS CO3 Aquitaine cohort

Abstract

Background The objective of the study was to describe the evolution of chronic non-AIDS related diseases and their risk factors, in patients living with HIV (PLHIV) in the French ANRS CO3 Aquitaine prospective cohort, observed both in 2004 and in 2014 in order to improve long-term healthcare management. Methods The ANRS CO3 Aquitaine cohort prospectively collects epidemiological, clinical, biological and therapeutic data on PLHIV in the French Aquitaine region. Two cross sectional analyses were performed in 2004 and 2014, to investigate the patient characteristics, HIV RNA, CD4 counts and prevalence of some common comorbidities and treatment. Results 2138 PLHIV (71% male, median age 52.2 years in 2014) were identified for inclusion in the study, including participants who were registered in the cohort with at least one hospital visit recorded in both 2004 and 2014. Significant increases in the prevalence of diagnosed chronic kidney disease (CKD), bone fractures, cardiovascular events (CVE), hypertension, diabetes and dyslipidaemia, as well as an increase in treatment or prevention for these conditions (statins, clopidogrel, aspirin) were observed. It was also reflected in the increase in the proportion of patients in the “high” or “very high” risk groups of the disease risk scores for CKD, CVE and bone fracture score. Conclusions Between 2004 and 2014, the aging PLHIV population identified in the French ANRS CO3 Aquitaine prospective cohort experienced an overall higher prevalence of non-HIV related comorbidities, including CKD and CVD. Long-term healthcare management and long-term health outcomes could be improved for PLHIV by: careful HIV management according to current recommendations with optimal selection of antiretrovirals, and early management of comorbidities through recommended lifestyle improvements and preventative measures.

A comprehensive analysis of excess depressive disorder in women and men living with HIV in France compared to the general population

“…We considered multimorbidity as the number of age-associated comorbidities (none to ≥ 3 comorbidities). In analyses conducted exclusively in PLWH, we considered commonly occurring comorbidities in PLWH as per previous analyses 11 , 22 . These included hypertension, diabetes mellitus type 2, chronic obstructive pulmonary disease, ischemic cardiac event (angina pectoris or myocardial infarction), ischemic cerebrovascular disease as well as impaired renal function, osteoporosis, peripheral arterial disease, and non-AIDS cancers, which were not available in the EHIS-ESPS survey.…”

Hepatocyte-Specific Triggering of Hepatic Stellate Cell Profibrotic Activation by Apoptotic Bodies: The Role of Hepatoma-Derived Growth Factor, HIV, and Ethanol

“…This is due to antiretroviral therapy (ART)-induced longevity, which conversely allows the incidence of age-related comorbidities not previously observed among PLWH. Given the impaired quality of life and outrageous incremental care cost for PLWH due to non-infection comorbidities [ 2 , 3 , 4 , 5 ], such as cardiovascular disease, liver disease, and alcohol use disorder [ 6 , 7 , 8 ], the management of PLWH in the ART era has become a critical economy and public health issue [ 5 ]. In response to this dilemma, our group explored the pathogenicity of HIV-induced liver injury in alcohol settings.…”

Weight of Clinical and Social Determinants of Metabolic Syndrome in People Living with HIV

“…Due to increased life expectancy and efficacy of newer antiretrovirals, the burden of non-infectious comorbidities in people living with HIV (PLWH) is increasing [1,2]. Indeed, cardiovascular disease, metabolic complications, cancer, and bone disorders are the most frequent comorbidities in this population [3,4].…”