HIV infection is related to a higher prevalence of diseases associated with aging
We also observed a higher prevalence of traditional risk factors of these diseases in this population group
According to a Dutch study, published in the electronic edition of the journal Clinical Infectious DiseasesThere seems to be a relationship between HIV infection and increased risk of suffering from various diseases associated with aging.
The research team compared the risk of suffering cardiovascular, renal and bone diseases among people with HIV of old age and a control group of seronegative persons with similar characteristics. The prevalence of these pathologies associated with aging was higher in the group of people with HIV, especially in the case of CVD and kidney. As might be expected, we found an association between the likelihood of developing these diseases and the presence of other risk factors more commonly referred to, but also associated the existence of HIV infection, and the immunosuppression period suffered and the presence of systemic inflammation.
The prevalence of comorbidity due to diseases associated with aging was significantly higher among those with HIV than those found in the control group. This phenomenon, also present in those cases of undetectable viral load, is compatible with the findings of previous research. Thus, a higher prevalence of geriatric syndromes with low CD4 counts was related months ago.
The improvements in the treatment and attention which did not prevent HIV infection in many cases, reach an advanced age. However, in these cases appears to be to produce an appearance of early age-related diseases. Are unknown the exact reasons why this occurs, but they include the classical risk factors (smoking, obesity, etc.), Side effects of antiretroviral therapy, inflammatory effects of HIV infection and the damage caused by the immunosuppression.
In 2010, a research team located in Amsterdam, the Netherlands, established a cohort to study the relationship between HIV and the diseases associated with aging. On this cohort, the study was developed that 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 people, adjusting the results of both groups by sex and age. Risk factors related to an increased risk of age-related comorbidity were also verified.
The study population included 540 people with HIV in one group and 524 seronegative people in the control group. The groups were adjusted for age, with the same average age (of 52 years). The majority of participants were men who had said sex practices with other men.
About a third of participants with HIV had been diagnosed with AIDS, but during the study the practical totality was consuming antiretroviral therapy and viral load was undetectable.
The prevalence of cardiovascular risk factors - smoking, high blood pressure, waist-chair index, physical inactivity - was significantly higher in the group with HIV than in the control group.
The overall prevalence of age-related comorbidity was also significantly higher among the HIV-positive group than in the control group, with a mean prevalence per participant of 1,3 versus 1,0 (p <0,001). Likewise, in the first group the probability of having several diseases associated with aging was significantly higher (p = 0,009). This higher prevalence occurred for all age groups considered (50-55, 60-65, 65 major). In addition, the time of onset of each disease associated with aging in people with HIV was about five years earlier than observed among those who were seronegative.
Considering each comorbidity separately, prevalence in the group of people with HIV was also significantly higher in all cases, especially in the case of hypertension (45 vs. 31%; p <0,001), myocardial infarction (4 vs. 2%, p <0,018 ), peripheral arterial disease (3 vs. 1%, p <0,008) and renal dysfunction (4 vs. 2%, p <0,044).
It was also found between the traditional risk factors (age, smoking, family history and index waist-chair) with higher comorbidity.
HIV infection acted as a risk factor independently, increasing the risk of suffering diseases associated with aging in more than 50% (odds ratio [CP]: 1,58; confidence interval 95% [IC95%]: 1,23 - 2,03; p <0.001).
By explicitly noted risk factors in the group with HIV, there is a first time to a longer period of HIV infection (p <0,001), a longer period receiving antiretroviral treatment (p <0,001) and a longer period with a CD4 count below 200 cells / mm3 (p <0,001) increased the risk of diseases associated with aging. However, after the elimination of possible confounding factors, only found statistically significant time of immunosuppression.
There was also a relationship between the risk of age-associated diseases and inflammatory markers. HIV infection is associated with inflammation, immune system activation and coagulation disorders usually considered causative of much higher comorbidity in people with HIV infection and those that are not infected by the virus.
Weather in treatment in complete dose ritonavir (Norvir) met at the limit of statistical significance.
The authors concluded that the study results would support the hypothesis that links HIV infection with premature aging. It is questionable whether this is due to the way HIV acts as an added risk factor to traditional, increasing total comorbidity, or whether HIV acts directly on the very biology of aging.
Jesús Damieta - 29 / 09 / 2014
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