Incident Non-AIDS Comorbidity Burden Among Women With or at Risk for Human Immunodeficiency Virus in the United States
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Human immunodeficiency virus (HIV) infection may accelerate development of aging-related non-AIDS comorbidities (NACMs). The incidence of NACMs is poorly characterized among women living with HIV (WLWH). METHODS: WLWH and HIV-seronegative participants followed in the Women's Interagency HIV Study (WIHS) through 2009 (when >80% of WLWH used antiretroviral therapy) or onward were included, with outcomes measured through 31 March 2018. Sociodemographics, clinical covariates, and prevalent NACM were determined at enrollment. We used Poisson regression models to determine incident NACM burden (number of NACMs accrued through most recent WIHS visit out of 10 total NACMs assessed) by HIV serostatus and age. RESULTS: There were 3129 participants (2239 WLWH, 890 HIV seronegative) with 36 589 person-years of follow-up. At enrollment, median age was 37 years, 65% were black, and 47% currently smoked. In fully adjusted analyses, WLWH had a higher incident NACM rate compared with HIV-seronegative women (incidence rate ratio, 1.36 [95% confidence interval (CI), 1.02-1.81]). Incident NACM burden was higher among WLWH vs HIV-seronegative women in most age strata (HIV × age interaction: P = .0438), and women <25 years old had the greatest incidence rate ratio by HIV serostatus at 1.48 (95% CI, 1.19-1.84) compared with those in older age groups. Incident NACM burden was associated with traditional comorbidity risk factors but not HIV-specific indices. CONCLUSIONS: Incident NACM burden was higher among WLWH than HIV-seronegative women. This difference was most dramatic among women aged <25 years, a group for whom routine comorbidity screening is not prioritized. Established non-HIV comorbidity risk factors were significantly associated with incident NACM burden. More data are needed to inform best practices for NACM screening, prevention, and management among WLWH, particularly young women.
Source: Clinical Infectious Diseases
DOI: 10.1093/cid/ciaa1928
Institutions: Grady Memorial Hospital, Emory University, Grady Health System, Duke University, Duke Clinical Research Institute, Johns Hopkins University, Albert Einstein College of Medicine, John H. Stroger, Jr. Hospital of Cook County, Georgetown University Medical Center, SUNY Downstate Health Sciences University, University of Miami, University of North Carolina at Chapel Hill, University of Alabama at Birmingham, Northwestern University, San Francisco VA Medical Center, University of California, San Francisco
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Gilead Sciences, Emory University, Northwestern University, Georgia Clinical and Translational Science Alliance, National Institutes of Health, Center for AIDS Research, University of Washington, University of California, San Francisco, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Cancer Institute, National Institute on Deafness and Other Communication Disorders, National Institute of Nursing Research, National Institute of Allergy and Infectious Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Child Health and Human Development, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1913134163, G2758923846, G3069811809, The Connie Wofsy Women's HIV Study, G5147848267, G5660189159, G5863844756, Clinical and Translational Science Institute, G5900455136, G6396423216, G687203789, G6990385686, G7140729675, G7152846654, G775892330, G7807729167, G9000080293, University of Pittsburgh MACS/WIHS CCS, MACS/WIHS -CCS, Emory Specialized Center of Research Excellence (SCORE) on Sex Differences, Institutional Career Development Core, SF Bay Area MACS/WIHS Combined Cohort Study, UNC MACS/WIHS Combined Cohort Study Clinical Research Site, Surviving the HIV Epidemic (S/HE) in metropolitan Washington DC - Advancing knowledge through cohort studies, Center for AIDS Research at Emory University, Northwestern CORE Clinical Research Site: Trans-omics for HIV/AIDS Research, Los Angeles CRS for the MACS/WIHS Combined Cohort Study, Data Analysis and Coordination Center for the MACS-WIHS Combined Cohort Study, MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS), The University of North Carolina Center for AIDS Research, Georgia Clinical & Translational Science Alliance (Georgia CTSA), MACS/WIHS Combined Cohort Study: Brooklyn Clinical Research Site (Bklyn CRS), UCSF-Bay Area Center for AIDS Research, Center for AIDS Research, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS) - Baltimore/Wash DC Center, Atlanta MACS/WIHS Combined Cohort Study Clinical Research Site, UAB-MISS MACS/WIHS Combined Cohort Study, Clinical Research Sites for the MACS/WIHS Combined Cohort Study (MACS/WIHS-CCS), UAB Center for AIDS Research (CFAR)
OpenAlex ID: W3119478845