TY - JOUR
T1 - Major health impact of accelerated aging in young HIV-infected individuals on antiretroviral therapy
AU - Rajasuriar, Reena
AU - Chong, Meng L.
AU - Ahmad Bashah, Nor S.
AU - Abdul Aziz, Siti A.
AU - Mcstea, Megan
AU - Lee, Erica C.Y.
AU - Wong, Pui L.
AU - Azwa, Iskandar
AU - Syed Omar, Sharifah F.
AU - Lai, Pauline S.M.
AU - Ponampalavanar, Sasheela
AU - Crowe, Suzanne M.
AU - Lewin, Sharon R.
AU - Kamaruzzaman, Shahrul B.
AU - Kamarulzaman, Adeeba
N1 - Publisher Copyright:
Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/6/19
Y1 - 2017/6/19
N2 - Background: Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls. Methods: HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community. All participants were aged at least 25 years of age with no acute illness, and HIV-infected individuals were on stable ART. Geriatric conditions were assessed and the burden scored as a composite of geriatric conditions present in an individual (total score = 10). Multivariate regression analysis was performed to determine the risk factors and health impact associated with the burden of geriatric conditions. Results: We analyzed data from 336 HIV-infected individuals (total HIV+), of whom 172 were matched for age, sex, and ethnicity with 172 HIV-uninfected controls (matched subset). In the total HIV-positive cohort, median (interquartile range) age was 44 (38-51) years and CD4+ T-cell count was 562 (398-737) cells/μl. The burden of geriatric conditions was significantly higher in the HIV-infected group compared with controls (P < 0.001). With an increasing geriatric condition burden, quality-of-life scores were 2.2-times poorer, healthcare use five times greater, and mortality risk scores four times higher in the HIV-infected group compared with matched controls. Both sociobehavioural and HIV-related clinical factors were independently associated with an increasing burden of geriatric condition in HIV. Conclusions:A high burden of geriatric conditions with significant impact on health outcomes, including mortality risk scores are observed among HIV-infected individuals on ART in a resource-limited setting.
AB - Background: Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls. Methods: HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community. All participants were aged at least 25 years of age with no acute illness, and HIV-infected individuals were on stable ART. Geriatric conditions were assessed and the burden scored as a composite of geriatric conditions present in an individual (total score = 10). Multivariate regression analysis was performed to determine the risk factors and health impact associated with the burden of geriatric conditions. Results: We analyzed data from 336 HIV-infected individuals (total HIV+), of whom 172 were matched for age, sex, and ethnicity with 172 HIV-uninfected controls (matched subset). In the total HIV-positive cohort, median (interquartile range) age was 44 (38-51) years and CD4+ T-cell count was 562 (398-737) cells/μl. The burden of geriatric conditions was significantly higher in the HIV-infected group compared with controls (P < 0.001). With an increasing geriatric condition burden, quality-of-life scores were 2.2-times poorer, healthcare use five times greater, and mortality risk scores four times higher in the HIV-infected group compared with matched controls. Both sociobehavioural and HIV-related clinical factors were independently associated with an increasing burden of geriatric condition in HIV. Conclusions:A high burden of geriatric conditions with significant impact on health outcomes, including mortality risk scores are observed among HIV-infected individuals on ART in a resource-limited setting.
KW - aging
KW - geriatric conditions
KW - health outcomes
KW - mortality risk scores
KW - polypathology
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=85016635785&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000001475
DO - 10.1097/QAD.0000000000001475
M3 - Article
C2 - 28358731
AN - SCOPUS:85016635785
SN - 0269-9370
VL - 31
SP - 1393
EP - 1403
JO - AIDS
JF - AIDS
IS - 10
ER -