Rate of cardiovascular, renal and bone disease and their major risks factors in HIV-infected individuals on antiretroviral therapy in Spain
Por:
Knobel H, Domingo P, Suarez-Lozano I, Gutierrez F, Estrada V, Palacios R, Antela A, Blanco JR, Fulladosa X, Refollo E and VACH Cohort
Publicada:
1 jun 2019
Categoría:
Microbiology (medical)
Resumen:
Background: The life expectancy of HIV-infected individuals has dramatically improved with potent antiretroviral therapies. However, organ-specific toxicities of some antiretrovirals and persistent inflammation and immune activation due to residual virus replication account for a high burden of age-associated comorbidities in the HIV population.
Methods: The prevalence of overt cardiovascular, renal and bone diseases as well as their major risk factors were cross-sectionally examined during the year 2014 in the VACH cohort, a large nationwide population of HIV-infected individuals in Spain.
Results: A total of 10,897 HIV-infected patients were examined. Seventy-one point four percent were male and the mean age was 48 years. Mean time since HIV diagnosis was 15.8 years and mean time on antiretroviral therapy was 13.1 years. The proportion of patients with undetectable viral load was 87.1%, whereas 65.7% had CD4 counts >500 cells/mm(3). Overall, cardiovascular, renal and bone disease were recorded in 4.7%, 5.9% and 2.8%, respectively. The prevalence of major risk factors was as follows: smoking 51.3%, alcohol abuse 7.8%, overweight/obesity 42.2%, diabetes 19.9%, dyslipidaemia 72.6%, hypertension 25.6%, and osteoporosis 11.1%. In the subset of patients older than 55 years-old (18%), all figures for overt disease and their major risk factors were significantly greater.
Conclusion: Major age-related medical conditions and most of their risk factors are highly prevalent in HIV-infected individuals on long-term antiretroviral therapy in Spain. Preventive actions, including careful selection of antiretroviral agents, should be prioritized in the ageing HIV population. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Enfermedades Infecciosas y Microbiologia Clinica. All rights reserved.
Filiaciones:
Knobel H:
Servicio Enfermedades Infecciosas, Hospital del Mar, Barcelona
Domingo P:
Unidad Enfermedades Infecciosas, Hospital de la Santa Creu I Sant Pau, Barcelona
Servicio Enfermedades Infecciosas
Suarez-Lozano I:
Hospital Infanta Elena, Huelva
:
Servicio Enfermedades Infecciosas, University General Hospital, Elche
Estrada V:
Servicio Enfermedades Infecciosas, Hospital Clinico San Carlos-IdiSSC, Madrid
Palacios R:
Servicio Enfermedades Infecciosas, Hospital Virgen de la Victoria, Malaga
Antela A:
Servicio Enfermedades Infecciosas, Hospital Clínico Universitario, Santiago
Blanco JR:
Servicio Enfermedades Infecciosas, Hospital de San Pedro, Logroño
Fulladosa X:
Servicio de Nefrología, Hospital Universitario de Bellvitge, Barcelona
Refollo E:
Servicio de Cardiología, Hospital Universitario La Paz, Madrid
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