Comparison of Risk and Age at Diagnosis of Myocardial Infarction, End-Stage Renal Disease, and Non-AIDS-Defining Cancer in HIV-Infected Versus Uninfected Adults

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 stu...

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Bibliographic Details
Published in:Clinical infectious diseases 2015-02, Vol.60 (4), p.627-638
Main Authors: Althoff, Keri N., McGinnis, Kathleen A., Wyatt, Christina M., Freiberg, Matthew S., Gilbert, Cynthia, Oursler, Krisann K., Rimland, David, Rodriguez-Barradas, Maria C., Dubrow, Robert, Park, Lesley S., Skanderson, Melissa, Shiels, Meredith S., Gange, Stephen J., Gebo, Kelly A., Justice, Amy C.
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Adult
Age
Aging
and Commentaries
Cohort Studies
Female
Heart attacks
HIV
HIV Infections - complications
HIV/AIDS
Human immunodeficiency virus
Humans
Kidney diseases
Kidney Failure, Chronic - diagnosis
Linear Models
Male
Medical diagnosis
Middle Aged
Myocardial Infarction - diagnosis
Neoplasms - diagnosis
Proportional Hazards Models
Prospective Studies
Risk
Risk factors
Veterans
Young Adult
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Summary: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.
ISSN:1058-4838
1537-6591
DOI:10.1093/cid/ciu869