Growing old with antiretroviral therapy or elderly people in antiretroviral therapy: two different profiles of comorbidity?

Autor: Maggi P; Department of Infectious Disease, University of Campania Luigi Vanvitelli, Naples, Italy., De Socio GV; Clinic of Infectious Diseases, Department of Medicine 2, Azienda Ospedaliera di Perugia, Santa Maria Hospital, Perugia, Italy., Menzaghi B; Unit of Infectious Diseases, ASST della Valle Olona, Busto Arsizio Hospital, Busto Arsizio, Italy., Molteni C; Infectious Disease Unit, Ospedale A. Manzoni, Lecco, Italy., Squillace N; Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy., Taramasso L; Infectious Disease Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy., Guastavigna M; Unit of Infectious Diseases, 'Divisione A', Amedeo di Savoia Hospital, Turin, Italy., Gamboni G; Clinic of Infectious Diseases, Department of Medicine 2, Azienda Ospedaliera di Perugia, Santa Maria Hospital, Perugia, Italy., Madeddu G; Unit of Infectious and Tropical Diseases, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy., Vichi F; Infectious Diseases Department, SOC 1, USLCENTRO Firenze, Santa Maria Annunziata Hospital, Florence, Italy., Cascio A; Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy., Sarchi E; Infectious Diseases Unit, SS. Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy., Pellicanò G; Unit of Infectious Diseases, Department of Human Pathology of the Adult and the Developmental Age 'G. Barresi', University of Messina, Messina, Italy., Martinelli CV; SOD Malattie Infettive e Tropicali AOU Careggi, Florence, Italy., Celesia BM; Unit of Infectious Diseases, University of Catania, ARNAS Garibaldi, Catania, Italy., Valsecchi L; Infectious Disease Unit, ASST Fatebenefratelli Sacco, Milan, Italy., Gulminetti R; Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy., Cenderello G; Infectious Diseases Department, Sanremo Hospital, Sanremo, Italy., Parisini A; Department of Infectious Diseases, Galliera Hospital, Genoa, Italy., Calza L; Department of Medical and Surgical Sciences, Clinics of Infectious Diseases, S. Orsola-Malpighi Hospital, 'Alma Mater Studiorum' University of Bologna, Bologna, Italy., Falasca K; Clinic of Infectious Diseases, Department of Medicine and Science of Aging, University 'G. d'Annunzio' Chieti-Pescara, Chieti, Italy., Orofino G; Unit of Infectious Diseases, 'Divisione A', Amedeo di Savoia Hospital, Turin, Italy., Ricci E; Fondazione ASIA Onlus, via Garibaldi, 13, 20090, Buccinasco, MI, Italy. ed.ricci@libero.it., Di Biagio A; Infectious Disease Clinic, IRCCS Policlinico San Martino Hospital, Genoa, Italy., Bonfanti P; Infectious Diseases Clinic, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2022 Sep 23; Vol. 22 (1), pp. 745. Date of Electronic Publication: 2022 Sep 23.
DOI: 10.1186/s12879-022-07739-y
Abstrakt: Background: In persons living with HIV (PLWH), the burden of non-communicable chronic diseases increased over time, because of aging associated with chronic inflammation, systemic immune activation, and long-term exposure to the combination antiretroviral therapy (ART).
Methods: To explore the association of chronological age, age at first ART, and exposure to ART with non-communicable chronic diseases, we performed a cross-sectional analysis to evaluate the prevalence of comorbidities in patients enrolled in the SCOLTA Project, stratified by groups of chronological age (50-59 and 60-69 years) and by years of antiretroviral treatment (ART, ≤ 3 or > 3 years).
Results: In 1394 subjects (23.8% women), mean age at enrollment was 57.4 (SD 6.5) years, and at first ART 45.3 (SD 10.7). Men were older than women both at enrollment (57.6 vs 56.8, p = 0.06) and at first ART (45.8 vs 43.6, p = 0.0009). ART duration was longer in women (13.1 vs 11.7 years, p = 0.01). The age- and sex-adjusted rate ratios (aRRs, and 95% confidence interval, CI) showed that longer ART exposure was associated with dyslipidemia (aRR 1.35, 95% CI 1.20-1.52), hypertension (aRR 1.52, 95% CI 1.22-1.89), liver disease (aRR 1.78, 95% CI 1.32-2.41), osteopenia/osteoporosis (aRR 2.88, 95% CI 1.65-5.03) and multimorbidity (aRR 1.36, 95% CI 1.21-1.54). These findings were confirmed in strata of age, adjusting for sex.
Conclusions: Our data suggest that longer ART exposure was associated with increased risk of dyslipidemia, hypertension, and osteopenia/osteoporosis, hence the presence of multimorbidity, possibly due to the exposition to more toxic antiretrovirals. We observed different comorbidities, according to ART exposure and age.
(© 2022. The Author(s).)
Databáze: MEDLINE
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