Marie Demontès1, Sabrina Eymard Duvernay2, Clotilde Allavena3, Thomas Jovelin3, Jacques Reynes4, Maxime Hentzien5, Isabelle Ravaux6, Pierre Delobel7, Sylvie Bregigeon8, David Rey9, Tristan Ferry10, Amandine Gagneux-Brunon11, Olivier Robineau12, Pascal Pugliese13, Claudine Duvivier14, André Cabié15, Catherine Chirouze16, Christine Jacomet17, Isabelle Lamaury18, Dominique Merrien19, Bruno Hoen16, Laurent Hocqueloux20, Antoine Cheret21,22, Christine Katlama23, Cédric Arvieux24, Pierre Krolak-Salmon1, Alain Makinson4. 1. Memory Clinical and Research Center of Lyon, Lyon Institute for Elderly, Hospices civils de Lyon, Université Lyon, Inserm, Lyon, France. 2. University of Montpellier, Unité TransVIHMI, France Institute of Research for Development Unité Mixte Internationale (UMI) 233, Inserm U1175, Montpellier, France. 3. Infectious Diseases Department, University of Nantes, Centre hospitalier universitaire Hôtel Dieu, Nantes, France. 4. Infectious and Tropical Diseases Department, Montpellier University Hospital, and UMI 233, Inserm U1175, Montpellier, France. 5. Reims Teaching Hospitals, Robert Debré Hospital, Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Reims, France. 6. Aix Marseille Université, Centre Nationale de la Recherche Scientifique (CNRS), Institut de Recherche pour le Développement (IRD), Inserm, Assistance Publique-Hôpitaux de Marseille (AP-HM), Unité de Recherche sur les Maladies Infectieuses, Institut Hospitalo-Universitaire (IHU) Méditerranée-Infection, Marseille, France. 7. Infectious and Tropical Diseases Department Inserm, Unité Mixte de Recherche (UMR) 1043, Toulouse, France. 8. Aix Marseille Universiteé, AP-HM Sainte-Marguerite, Marseille, France. 9. University Hospitals of Strasbourg, Nouvel Hôpital Civil, Human Immunodeficiency Virus Care Center, Strasbourg, France. 10. Infectious Diseases Department, Hospices Civils de Lyon, Claude Bernard Lyon 1 University, Lyon, France. 11. Department of Infectious and Tropical Diseases, Centre hospitalier universitaire Saint-Etienne, Groupe Immunité des Muqueuses et Agents Pathogènes, Jean Monnet University, University of Lyon, Saint-Etienne, France. 12. Infectious Diseases Department, Gustave Drion Hospital, Tourcoing, France. 13. Infectious Diseases Department, University of Nice, Centre hospitalier universitaire L'Archet, Nice, France. 14. Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants malades, Infectious and Tropical Diseases Department, Institut Pasteur, Centre Médical de l'Institut Pasteur, Infectious Diseases Centre Necker-Pasteur, IHU Imagine, Institut Cochin, CNRS 8104, Inserm U1016, Paris, France. 15. Clinical Investigation Centre, Antilles Guyane, Inserm 1424 and Infectious and Tropical Diseases Department, Centre Hospitalier Universitaire de la Martinique and University of the Antilles, Equipe d'Acceuil, Fort-de-France, France. 16. Infectious and Tropical Diseases Department, Centre Hospitalier Regional Universitaire Besançon, UMR CNRS 6249 Bourgogne Franche Comté University, Besançon, France. 17. Infectious Diseases Department, Centre hospitalier universitaire Clermont-Ferrand, Clermont-Ferrand, France. 18. Department of Infectious and Tropical Diseases, Dermatology, Internal Medicine, University Hospital Guadeloupe, Pointe-à-Pitre, France. 19. Internal Medicine Department, Centre Hospitalier Vendée (CHD) Vendée, La Roche-sur-Yon, France. 20. Department of Infectious and Tropical Diseases, Centre hospitalier universitaire d'Orléans-La Source, Orléans, France. 21. Internal Medicine Department, Centre hospitalier universitaire Bicètre, Bicètre, France. 22. University of Paris Descartes, Sorbonne Paris Cité, Paris, France. 23. Sorbonne Université, Inserm, Pierre Louis Institute of Epidemiology and Public Health, Unité Mixte de Recherche en Santé 1136, AP -HP, Hôpitaux Universitaires Pitié Salpêtrière-Charles Foix, Department of Infectious and Tropical Diseases, Paris, France. 24. Centre hospitalier universitaire Rennes, Infectious Diseases and Intensive Care Unit, Rennes, France.
Abstract
BACKGROUND: We assessed prevalence of multimorbidity (MM) according to year of human immunodeficiency virus (HIV) diagnosis in elderly people living with HIV (PLWH). METHODS: This was a cross-sectional study of MM in PLWH aged ≥70 years from the Dat'AIDS French multicenter cohort. MM was defined as at least 3 coexistent morbidities of high blood pressure, diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardiovascular and cerebrovascular disease, obesity, undernutrition, or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV diagnosis (1983-1996, 1997-2006, and 2007-2018). The secondary analysis evaluated MM as a continuous outcome, and a sensitivity analysis excluded PLWH with nadir CD4 count <200 cells/μL. RESULTS: Between January 2017 and September 2018, 2476 PLWH were included. Median age was 73 years, 75% were men, median CD4 count was 578 cells/μL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, hepatitis C and hepatitis B virus coinfection, group of exposure, nadir CD4 count, CD4:CD8 ratio, and last CD4 level, calendar period of diagnosis was not associated with MM (P = .169). MM was associated with older age, CD4/CD8 ratio <0.8, and nadir CD4 count <200 cells/μL. Similar results were found with secondary and sensitivity analyses. CONCLUSIONS: MM prevalence was high and increased with age, low CD4/CD8 ratio, and nadir CD4 count <200 cells/μL but was not associated with calendar periods of HIV diagnosis. Known duration of HIV diagnosis does not seem to be a criterion for selecting elderly PLWH at risk of MM.
BACKGROUND: We assessed prevalence of multimorbidity (MM) according to year of human immunodeficiency virus (HIV) diagnosis in elderly people living with HIV (PLWH). METHODS: This was a cross-sectional study of MM in PLWH aged ≥70 years from the Dat'AIDS French multicenter cohort. MM was defined as at least 3 coexistent morbidities of high blood pressure, diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardiovascular and cerebrovascular disease, obesity, undernutrition, or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV diagnosis (1983-1996, 1997-2006, and 2007-2018). The secondary analysis evaluated MM as a continuous outcome, and a sensitivity analysis excluded PLWH with nadir CD4 count <200 cells/μL. RESULTS: Between January 2017 and September 2018, 2476 PLWH were included. Median age was 73 years, 75% were men, median CD4 count was 578 cells/μL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, hepatitis C and hepatitis B virus coinfection, group of exposure, nadir CD4 count, CD4:CD8 ratio, and last CD4 level, calendar period of diagnosis was not associated with MM (P = .169). MM was associated with older age, CD4/CD8 ratio <0.8, and nadir CD4 count <200 cells/μL. Similar results were found with secondary and sensitivity analyses. CONCLUSIONS: MM prevalence was high and increased with age, low CD4/CD8 ratio, and nadir CD4 count <200 cells/μL but was not associated with calendar periods of HIV diagnosis. Known duration of HIV diagnosis does not seem to be a criterion for selecting elderly PLWH at risk of MM.
Authors: Casey L Smiley; Peter F Rebeiro; Carina Cesar; Pablo F Belaunzaran-Zamudio; Brenda Crabtree-Ramirez; Denis Padgett; Eduardo Gotuzzo; Claudia P Cortes; Jean Pape; Valdiléa G Veloso; Catherine C McGowan; Jessica L Castilho Journal: Lancet HIV Date: 2021-04-20 Impact factor: 12.767
Authors: Chun-Shu Wong; Clarisa M Buckner; Silvia Lucena Lage; Luxin Pei; Felipe L Assis; Eric W Dahlstrom; Sarah L Anzick; Kimmo Virtaneva; Adam Rupert; Jeremy L Davis; Ting Zhou; Elizabeth Laidlaw; Maura Manion; Frances Galindo; Megan Anderson; Catherine A Seamon; Michael C Sneller; Andrea Lisco; Claire Deleage; Stefania Pittaluga; Susan Moir; Irini Sereti Journal: Front Immunol Date: 2021-12-01 Impact factor: 7.561