Lars Jørgen Østergaard

Aging and the evolution of comorbidities among HIV-positive individuals in a European cohort

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

  • Annegret Pelchen-Matthews, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
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  • Lene Ryom, University of Copenhagen
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  • Álvaro H Borges, University of Copenhagen
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  • Simon Edwards, Mortimer Market Centre, London, UK.
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  • Claudine Duvivier, AP-HP-Necker Hospital, Infectious Diseases Department, Necker-Pasteur Infectiology Center, Paris Descartes University, Sorbonne Paris Cité, EA7327, IHU Imagine, Paris, France.
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  • Christoph Stephan, Infectious Diseases Unit, Goethe University Hospital, Frankfurt, Germany.
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  • Helen Sambatakou, Ippokration General Hospital, Athens, Greece.
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  • Katarzyna Maciejewska, Pomeranian Medical University, Szczecin, Poland
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  • José Joaquín Portu, Hospital Universitario Araba, Department of Internal Medicine, Vitoria-Gasteiz, Álava, Spain
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  • Jonathan Weber, Dept. of Neurology, St. Mary's Hospital, London
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  • Olaf Degen, Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, 20246 Hamburg, Germany.
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  • Alexandra Calmy, Hopital Cantonal Universitaire Geneve, Geneva, Switzerland.
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  • Dag Henrik Reikvam, Ullevaal University Hospital, Oslo, Norway.
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  • Djordje Jevtovic, Belgrade University School of Medicine, Infectious & Tropical Diseases Hospital, Serbia.
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  • Lothar Wiese, Sjællands Universitetshospital, Roskilde, Denmark.
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  • Jelena Smidt, Nakkusosakond Siseklinik, Kohtla-Järve, Estonia.
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  • Tomasz Smiatacz, Department of Pathomorphology, Medical University of Gdansk, Gdansk, Poland.
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  • Gamal Hassoun, Oncology Institute, Rambam Medical Center, Haifa, Israel.
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  • Anastasiia Kuznetsova, Kharkov State Medical University, Khrakov, Ukraine.
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  • Bonaventura Clotet, 24 Hospital Germans Trias i Pujol, Badalona, Spain.
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  • Jens Lundgren, University of Copenhagen
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  • Amanda Mocroft, Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME), Institute for Global Health, University College London, London, UK.
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  • EuroSIDA study

OBJECTIVES: To describe changes in the prevalence of comorbidities and risk factors among HIV-positive individuals in the EuroSIDA study.

DESIGN: Comparison of two cross-sectional cohorts of HIV-positive adults under active follow-up in 2006 and 2014.

METHODS: Baseline demographics and prevalence of comorbidities were described. Factors associated with the prevalence of chronic kidney disease (CKD) and cardiovascular disease (CVD) were assessed by logistic regression modelling using generalized estimating equations.

RESULTS: Nine thousand, seven hundred and ninety-eight individuals were under active follow-up in EuroSIDA during 2006 and 12 882 during 2014. Compared with study participants in 2006, those in 2014 were older [median age 48.6 years (IQR 40.3-55.1) vs. 43.1 years (37.2-50.0) in 2006] and had higher prevalence of hypertension (59.6 vs. 47% in 2006), diabetes (6.3 vs. 5.4%), CKD (6.9 vs. 4.1%) and CVD (5.0 vs. 3.7%). Individuals in the 2014 cohort had higher odds for CKD (unadjusted OR 2.62, 95% CI 2.30-2.99, P < 0.0001) and CVD (OR 1.88, CI 1.68-2.10, P < 0.0001), but after multivariable adjustment for age group, comorbidities and other factors, year of cohort was no longer significantly associated with the odds of CKD [adjusted OR (aOR) 0.97, CI 0.52-1.82, P = 0.92) or of CVD (aOR 0.94, CI 0.54-1.63, P = 0.82).

CONCLUSION: Between 2006 and 2014, the population aged and experienced an overall higher prevalence of non-AIDS comorbidities, including CKD and CVD. The increase in CVD could be explained by the aging population, and the increase in CKD by aging and changes in other factors. Treatment strategies balancing HIV outcomes with long-term management of comorbidities remain a priority.

Original languageEnglish
JournalAIDS (London, England)
Volume32
Issue16
Pages (from-to)2405-2416
Number of pages12
ISSN0269-9370
DOIs
Publication statusPublished - 23 Oct 2018

    Research areas

  • Adult, Age Factors, Aged, Aged, 80 and over, Aging, Cardiovascular Diseases/epidemiology, Comorbidity, Cross-Sectional Studies, Europe/epidemiology, Female, HIV Infections/complications, Humans, Male, Middle Aged, Prevalence, Renal Insufficiency, Chronic/epidemiology, Risk Factors

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