H5. Complications and co-infections
Oral Abstract Submission
Lauren F. Collins, MD
Infectious Diseases Fellow
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, and Grady Healthcare System, Infectious Diseases Program
Atlanta, GA
Disclosure: Nothing to disclose
Anandi N. Sheth, MD, MS
Associate Professor of Medicine
Emory University
Atlanta, GA
Disclosure: Gilead Sciences, Inc.: Research Grant
C. Christina. Mehta, PhD, MSPH
Assistant Professor and Associate Director of Biostatistics Collaboration Core
Atlanta Women’s Interagency HIV; Emory University, Rollins School of Public Health, Department of Biostatistics and Bioinformatics
Atlanta, GA
Disclosure: Nothing to disclose
Elizabeth T. Golub, PhD, MPH, MEd
Director, Online Programs for Applied Learning and Senior Lecturer
Johns Hopkins
Baltimore, MD
Disclosure: Nothing to disclose
Phyllis C. Tien, MD, MSc
Professor of Medicine
Division of Infectious Diseases, Department of Medicine, University of California, San Francisco, San Francisco, California and Medical Service, Department of Veterans Affairs, San Francisco, California
San Francisco, CA
Disclosure: Nothing to disclose
Kathryn Anastos, MD
Professor of Medicine, Epidemiology & Population Health, OB/GYN & Women's Health
Department of Medicine, Albert Einstein College of Medicine, Bronx, New York
Bronx, NY
Disclosure: Nothing to disclose
Audrey L. French, MD
Professor of Medicine
Rush University Medical Center
Chicago, IL
Disclosure: Nothing to disclose
Seble Kassaye, MD, MS
Associate Professor of Medicine
Georgetown University Medical Center, Washington, DC
Washington, DC
Disclosure: Nothing to disclose
Tonya Taylor, PhD
Asssistant Professor
SUNY Downstate Medical Center
Brooklyn, NY
Disclosure: Nothing to disclose
Mirjam-Colette Kempf, PhD, MPH
Professor of Nursing
Schools of Nursing, Public Health and Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Birmingham, AL
Disclosure: Nothing to disclose
Margaret A. Fischl, MD
Professor of Medicine
Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, Florida
Miami, FL
Disclosure: Nothing to disclose
Adaora A. Adimora, MD, MPH
Professor of Medicine and Epidemiology
University of North Carolina
Chapel Hill, North Carolina
Disclosure: Nothing to disclose
Frank J. Palella, MD
Professor of Medicine
Division of Infectious Diseases, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
Chicago, IL
Disclosure: Nothing to disclose
Igho Ofotokun, MD, MS
Professor of Medicine
Emory University
Atlanta, GA
Disclosure: Nothing to disclose
Background : Age-related non-AIDS comorbidities (NACM) increasingly account for morbidity and mortality in persons living with HIV. The burden of NACM and its association with HIV is poorly described in women.
Methods : We analyzed data from HIV+ and at-risk HIV- participants who were followed in the Women’s Interagency HIV Study (WIHS) after 2009 (when > 80% of participants used antiretroviral therapy). Prevalence of each NACM (defined by a combination of self-report, clinical measurements, and laboratory data) and number of NACM were summarized at most recent follow-up visit and were compared by age and HIV serostatus using unadjusted linear regression models.
Results : There were 3232 women (2309 HIV+, 923 HIV-) with median follow-up of 15.3 years. Median age was 50 years, 65% were black, 38% currently smoked, 71% had ever used illicit drugs, 50% had annual income < $12,000, and median body mass index was 30 kg/m2. HIV+ women had a median CD4 count of 618 cells/mm3 and 66% had HIV viral suppression. Among 10 NACM evaluated, the following were more prevalent in HIV+ vs. HIV- women (all p < 0.01): psychiatric illness (57%/48%), liver disease (45%/26%), hyperlipidemia (40%/35%), bone disease (40%/33%), chronic kidney disease (15%/7%) and non-AIDS cancer (11%/7%). There was little difference in the prevalence of hypertension (66%/64%), lung disease (41%/43%), diabetes (22%/24%) and cardiovascular disease (19%/19%). Mean number of NACM was higher in HIV+ vs. HIV- women (3.6 vs. 3.0, p < 0.0001). Regardless of HIV serostatus, NACM burden significantly increased with age (p < 0.0001). Compared to women aged < 40 of the same HIV serostatus, the estimated mean difference in NACM (HIV+/HIV-) for those 40-49, 50-59, ≥ 60 years was 1.1/0.7, 2.3/2.3, and 3.6/3.2, respectively (p < 0.0001 for all). Within-age-group comparisons revealed significantly greater NACM burden in HIV+ vs. HIV- women aged 40-49 years (p < 0.0001) and ≥ 60 years (p=0.003), but not in those aged < 40 or 50-59 years (HIV*age interaction p=0.02) (Figure).
Conclusion : NACM burden was high in both HIV+ and at-risk HIV- women, but higher in HIV+ women overall and in certain age groups. Accumulation of NACM has complex implications for clinical care, medication management, and healthcare screening that must be further examined in this population.
