Middle-aged seropositives are at increased risk of "silent cerebral vascular disease"
Well, I, Claudius, am getting older and it is natural to seek out and share, as well, things that concern me directly, as well as those that concern other people in similar condition. The truth is that I try to pay attention to the "everything" I encounter, but this is particularly important to me and others in aging. It is also necessary to explain that the entry means the worst moment within a given concept
The prevalence of silent disease in small cerebral vessels in PLHA - (people living with HIV or AIDS - an important precursor to more serious conditions - is significantly higher among middle-aged people among HIV-positive people compared to other controls in the general population, according to research published in French inClinical Infectious Diseases.
After controlling for age, blood pressure and other traditional risk factors, the researchers found that HIV was associated with a doubling of the risk of silent PPVHA. HIV-reactive persons aged between 50 and 54 years had a high risk of the state compared to their HIV-negative peers.
"Our PPVHA study results revealed a high prevalence among middle-aged PLHA [people living with HIV or AIDS], despite shopping [antiretroviral therapy combination] - sustained immune and virological control," the authors write. "We have confirmed classical risk factors, such as hypertension and the onset of age, and have identified a certain factor associated with HIV, the nadir of the CD4 cell count." PPVHA encompasses a variety of abnormalities that affect blood vessels in the brain. In the general population, it is an important cause of cognitive impairment, frailty, gait changes, and is the second leading cause of dementia in the elderly.
Age and hypertension are known risk factors, but their association with HIV is unclear.
Researchers in France thus conducted a cross-sectional study involving people of middle-aged seropositive people, all of whom were doing well on antiretroviral therapy, and combined HIV-negative controls.
The objective was to compare the prevalence of PPVHA and severe PPVHA, according to HIV infection. MRI - recognized the gold standard was used to diagnose PPVHA.
All HIV-positive people had 50 or older, were taking long-term antiretroviral therapy and sustained virological suppression. Exclusion criteria were hepatitis C virus infection, co-infection, drug use or alcohol abuse, and diagnosis of neurological disease.
The final population of the study was composed of 456 people with HIV reagents and 156 controls. Recruitment occurred between 2013 and 2016.
HIV-reactive persons were younger than controls (median age of 56 vs. 58 years, p = 0,001) and also were more likely to be male (85 vs. 77%, p = 0,03).
Approximately two-thirds of the HIV-positive patients sample had been diagnosed prior to the introduction of effective antiretroviral treatment systems in 1996. Nadir median and CD4 cell counts were 196 and 665 cells / mm3, respectively.
PPVHA was detected in 52% of people with HIV reagents compared to 36% of controls. Severe PPVHA was present in one-fifth of HIV-positive patients and 14% of HIV-negative people.
After adjusting for age, sex, alcohol use, blood pressure, lipids and history of cardiovascular disease, the researchers found that PPVHA was significantly more prevalent in people with HIV reagents than controls (IAO = 2,3; 95% IC, 1.5-3.6); however, there was no association between HIV and the risk of severe PPVHA.
Overall, the risk of PPVHA increased with age.
Nonetheless, younger seropositive participants (50 to 54 years) had a five-fold increase in the risk of PPVHA compared to age-matched controls; the risk was three times higher in individuals with HIV infection, aged between 54 and 60.
Risk factors for PPVHA in people with HIV reagents included a nadir of ***** CD4 cells below 200 cells / mm3 (IAO = 1,5; 95% IC, 1,0 to 3).
"The results of the recent study showing links between PPVHA and cognitive and gait stopping, fragility and stroke in the general population and PLHA medical providers should warn to research PPVHA in PLHA - People Living With HIV or AIDS - by using a brief" , conclude the authors, who recommend that screening should be especially geared towards people over 60 years old.
Translator's Note: This, kind of edited, was what I managed to "raise" to disassociate this entry "nadir"... Please do not panic and talk to your doctors.
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