Greater prevalence of traditional risk factors for such disorders in this population group was also observed.
According to a Dutch study, published in the online edition of the journal Clinical Infectious DiseasesThere seems to be a relationship between HIV infection and increased risk of many diseases associated with aging.
The research team compared the risk of cardiovascular, renal and bone in elderly people infected with HIV disease and a control group consisting of HIV-negative individuals with similar characteristics. The prevalence of these diseases associated with aging was greater in people with HIV, especially in the case of cardiovascular and renal diseases. As expected, an association was found between the likelihood of developing these diseases and the presence of other risk factors most commonly reported, but is also related to the presence of HIV infection, with the period of continuous immunosuppression and the presence of systemic inflammation .
The prevalence of comorbidities associated with aging was significantly higher among those with HIV than in the control group. This phenomenon, which is also present in cases of undetectable viral load is consistent with the results of previous research. So a few months ago, a higher prevalence of geriatric syndromes was associated with lower scores CD4 (see News La del Día, 25 / 03 / 2014).
Improvements in the treatment and care have made HIV infection does not prevent that, in many cases, reach an advanced age. However, in these cases it appears that an early onset of age-related diseases occurs. The exact reason why this occurs is unknown, but can be counted risk factors including classical (smoking, obesity, etc.), side effects of antiretroviral therapy, inflammatory effects of HIV infection and damage immunosuppression.
In 2010, a research team based in Amsterdam (Netherlands) established a working group to study the relationship between HIV and diseases associated with aging. About this group now appears that the study compared, for a period of two years, the prevalence of diseases associated with aging, among a group of people with HIV infection and a control group composed of seronegative developed by fitting the results developed both groups by gender and age. Risk factors associated with increased risk of age-related comorbidities were also examined.
The study population included 540 people with HIV in a group and 524 seronegative persons in the control group. The groups were adjusted for age, with the same average age (years 52). Most participants were men who had undergone the practice of sex with men.
About a third of the participants had been diagnosed with HIV before AIDS, but in almost all the study were on antiretroviral therapy and viral load was undetectable.
The prevalence of cardiovascular risk factors for smoking - high blood pressure, waist-hip ratio, physical inactivity - was significantly higher in HIV-positive group than in the control group.
The prevalence of age-related comorbidities, was also significantly greater among people with HIV than in the control groupWith an average prevalence of 1,3 per participant versus 1,0 (p <0,001). Similarly, the first group the likelihood of various diseases associated with aging was significantly higher (p = 0,009). The highest prevalence occurred in all age ranges (50-55, 60-65, over 65 years). Furthermore, the time of occurrence of each of the diseases associated with aging in people with HIV predates by about five years the incidence observed among seronegative.
Considering each comorbidity separately, the prevalence in people with HIV was also significantly higher in all cases, especially in the case of hypertension (vs 45 31%, P <0,001), myocardial infarction (vs 4 2%, p <0,018 ), peripheral arterial disease (3 against 1%, p <0,008) and renal dysfunction (4 vs 2%, P <0,044).
Relationship between traditional risk factors (age, smoking, family history and waist-hip ratio) with higher comorbidity was also found.
HIV infection as a risk factor acted independently, increasing the risk associated with aging in over 50% (Likelihood ratio [CP] disease: 1,58, confidence interval 95% [95% CI]: 1,23-2,03, P <0,001).
By explicitly noted risk factors observed in the HIV positive group can be noted, first, that a long period of HIV infection (p <0,001), an antiretroviral longer period of treatment compliance (p < 0,001) and an extended period with a score of less than CD4 200 cells / mm 3 (p <0,001) increased the risk of age-related diseases. However, after eliminating potential confounding factors, we found only statistically significant time of immunosuppression.
Relationship between the risk of comorbidity and markers of inflammation was also found. HIV infection is associated with inflammation, immune system activation and coagulation disorders commonly considered to cause much greater comorbidity in people with HIV as those not infected with the virus.
The treatment time in full-dose ritonavir (Norvir) was found at the limit of statistical significance.
The authors concluded that the study results support the hypothesis that HIV infection is associated with premature aging. Remains a question as to whether this is due to HIV act as an additional risk factor to traditional front, increasing morbidity, or HIV acts directly on the biology of aging.
Source: Aidsmap / Prepared (gTt-VIH).
Reference: Schouten J et al. Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals: the AGEh IV cohort study. Clin Infect Dis, online edition, 2014.
Original in Spanish: http://gtt-vih.org/actualizate/la_noticia_del_dia/29-09-14
Translation: Eliane Mendes de Lima
Jesús Damietta - 29 / 09 / 2014Copyscape has not detected any matches for the current post. (1041 words checked)