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Journal Articles Clinical Infectious Diseases Year : 2020

Multimorbidity in Elderly Persons According to the Year of Diagnosis of Human Immunodeficiency Virus Infection: A Cross-sectional Dat’AIDS Cohort Study

1 HCL - Hospices Civils de Lyon
2 TransVIHMI - Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes
3 IRD - Institut de Recherche pour le Développement
4 Service de maladies infectieuses et tropicales [Nantes]
5 UN - Université de Nantes
6 UM - Université de Montpellier
7 CHU Reims - Centre Hospitalier Universitaire de Reims
8 SMIT - Service des Maladies Infectieuses et Tropicales [Hôpital de la Conception]
9 CPTP - Centre de Physiopathologie Toulouse Purpan
10 Service d'Immuno-hématologie clinique [Hôpital Sainte Marguerite - APHM]
11 CHU Strasbourg
12 StaPath - Pathogénie des Staphylocoques – Staphylococcal Pathogenesis
13 GIMAP - Groupe Immunité des Muqueuses et Agents Pathogènes
14 Service Universitaire des Maladies Infectieuses et du Voyageur [Tourcoing]
15 Service de Maladies Infectieuses [Nice]
16 CHU Necker - Enfants Malades [AP-HP]
17 CMIP - Centre Médical de l'Institut Pasteur
18 CIC - Antilles Guyane - Centre d'investigation clinique Antilles-Guyane
19 LCE - Laboratoire Chrono-environnement (UMR 6249)
20 Service des Maladies Infectieuses et Tropicales [CHU Clermont-Ferrand]
21 Service des maladies infectieuses
22 CHD Vendée - Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon
23 Service des maladies infectieuses et tropicales
24 CHRO - Centre Hospitalier Régional d'Orléans
25 Laboratoire de Virologie [CHU Necker]
26 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
27 Service des maladies infectieuses et réanimation médicale [Rennes] = Infectious Disease and Intensive Care [Rennes]
Marie Demontès
  • Function : Author
  • PersonId : 1066174
Maxime Hentzien
David Rey
  • Function : Author
  • PersonId : 912858
Isabelle Lamaury
  • Function : Author
  • PersonId : 950883
Bruno Hoen
Laurent Hocqueloux
  • Function : Author
  • PersonId : 917127
Pierre Krolak-Salmon
  • Function : Author
  • PersonId : 920058

Abstract

OBJECTIVE: We assessed prevalence of multimorbidity (MM) according to year of HIV diagnosis in people living with HIV (PLHIV) of geriatric age. DESIGN: Cross-sectional study of MM in PLHIV over 70 years old from the Dat'AIDS French multicentric cohort. MM was defined as at least three co-existent morbidities of either high blood pressure (HBP), diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardio and cerebrovascular disease, obesity, cachexia or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV-diagnosis (1983-1996, 1997-2006 and 2007-2018). The secondary analysis evaluated MM as a continuous outcome and a sensitivity analysis excluded PLHIV with nadir TCD4 cells < 200 cells/mm3. RESULTS: Between January 2017 and September 2018, 2476 PLHIV were included. Median age was 73 years old, 75% were men, median CD4 was 578 cells/mL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, HCV, HBV co-infection, group of exposure, nadir CD4, and CD4:CD8 ratio and last CD4 levels, calendar periods of diagnosis was not associated with MM (p=0.169). MM was associated with older age, CD4/CD8 ratio < 0.8 and nadir CD4 cells < 200 cells/mL. Similar results were found with secondary and sensitivity analyses. CONCLUSION: MM prevalence was high and increased with age, low CD4/CD8 ratio and nadir CD4 cells < 200mm3 but was not associated with calendar periods of HIV-diagnosis. Known duration of HIV-diagnosis does not seem a criterion for selecting elderly PLHIV at risk of MM.
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Dates and versions

hal-02504215 , version 1 (10-03-2020)

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Marie Demontès, Sabrina Eymard-Duvernay, Clotilde Allavena, Thomas Jovelin, Jacques Reynes, et al.. Multimorbidity in Elderly Persons According to the Year of Diagnosis of Human Immunodeficiency Virus Infection: A Cross-sectional Dat’AIDS Cohort Study. Clinical Infectious Diseases, 2020, ⟨10.1093/cid/ciz1171⟩. ⟨hal-02504215⟩
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