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