Impact of Age-related Comorbidities on Five-year Overall Mortality among Elderly HIV-Infected Patients in the Late HAART Era--Role of Chronic Renal Disease.
J Nutr Health Aging
; 20(4): 408-14, 2016 Apr.
Article
en En
| MEDLINE
| ID: mdl-26999241
ABSTRACT
OBJECTIVES:
To identify main prognostic factors for 5-year mortality among age-related comorbidities (ARCs) in older people living with HIV (PLHIV).DESIGN:
A prospective, multicentre cohort study with a 5-year follow-up period in the late HAART era (from January 2008 to December 2012).SETTING:
The Dat'AIDS cohort involving 12 French hospitals.PARTICIPANTS:
All actively followed HIV-1 infected patients aged 60 or older. MEASUREMENTS The study endpoint was all-cause five-year mortality. The following ARCs were considered chronic renal disease, cardiovascular diseases, cancer, chronic pulmonary disease, cirrhosis, diabetes and nutritional status. Hepatitis C (HCV), hepatitis B (HBV) co-infection and sociodemographic characteristics were also evaluated. Cox's Proportional Hazards model was used for multivariate analysis.RESULTS:
Among 1415 PLHIV aged 60 or more patients included, mean age was 66±5.5 years; 154 died (mortality rate 2.47/100 patient-years). The most prevalent ARCs were chronic renal disease (20.1%), diabetes (14.2%) and cardiovascular diseases (12.2%). By multivariate analysis, chronic renal disease (adjusted hazard ratio (aHR)=2.25; 95% confidence interval (CI) [1.58-2.21]; p<10-4), cardiovascular diseases (aHR=2.40; 95%CI[1.64-3.52]; p<10-4), non-HIV related cancer (aHR=1.91; 95%CI[1.20-3.05]; p=0.007), cirrhosis (aHR=2.99; 95%CI[1.68-5.33]; p<10-3), HCV co-infection (aHR=2.00; 95%CI[1.18-3.38]; p=0.009), low body mass index (aHR=2.42; 95%CI[1.46-4.01]; p<10-3) and CD4 cell count < 200 cells/µl (aHR=2.23; 95%CI[1.36-3.65]; p=0.002) were independently associated with 5 year mortality.CONCLUSION:
Due to a high prevalence, chronic renal disease and cardiovascular disease are main prognostic factors for 5-year mortality among aged PLHIV.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Envejecimiento
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Infecciones por VIH
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Fármacos Anti-VIH
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Terapia Antirretroviral Altamente Activa
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Insuficiencia Renal Crónica
Tipo de estudio:
Clinical_trials
/
Etiology_studies
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Incidence_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Nutr Health Aging
Asunto de la revista:
CIENCIAS DA NUTRICAO
/
GERIATRIA
Año:
2016
Tipo del documento:
Article