Keri N Althoff1, Kathleen A McGinnis2, Christina M Wyatt3, Matthew S Freiberg4, Cynthia Gilbert5, Krisann K Oursler6, David Rimland7, Maria C Rodriguez-Barradas8, Robert Dubrow9, Lesley S Park9, Melissa Skanderson9, Meredith S Shiels10, Stephen J Gange1, Kelly A Gebo1, Amy C Justice9. 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.
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.
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