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Impact of age-related comorbidities on five-year overall mortality among elderly HIV-infected patients in the late HAART era — Role of chronic renal disease

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To identify main prognostic factors for 5-year mortality among age-related comorbidities (ARCs) in older people living with HIV (PLHIV).

Design

A prospective, multicentre cohort study with a 5-year follow-up period in the late HAART era (from January 2008 to December 2012).

Setting

The Dat’AIDS cohort involving 12 French hospitals.

Participants

All actively followed HIV-1 infected patients aged 60 or older.

Measurements

The study endpoint was all-cause five-year mortality. The following ARCs were considered: chronic renal disease, cardiovascular diseases, cancer, chronic pulmonary disease, cirrhosis, diabetes and nutritional status. Hepatitis C (HCV), hepatitis B (HBV) co-infection and sociodemographic characteristics were also evaluated. Cox’s Proportional Hazards model was used for multivariate analysis.

Results

Among 1415 PLHIV aged 60 or more patients included, mean age was 66±5.5 years; 154 died (mortality rate 2.47/100 patientyears). The most prevalent ARCs were chronic renal disease (20.1%), diabetes (14.2%) and cardiovascular diseases (12.2%). By multivariate analysis, chronic renal disease (adjusted hazard ratio (aHR)=2.25; 95% confidence interval (CI) [1.58-2.21]; p<10-4), cardiovascular diseases (aHR=2.40; 95%CI[1.64-3.52]; p<10-4), non-HIV related cancer (aHR=1.91; 95%CI[1.20-3.05]; p=0.007), cirrhosis (aHR=2.99; 95%CI[1.68-5.33]; p<10-3), HCV co-infection (aHR=2.00; 95%CI[1.18-3.38]; p=0.009), low body mass index (aHR=2.42; 95%CI[1.46-4.01]; p<10-3) and CD4 cell count < 200cells/μl (aHR=2.23; 95%CI[1.36-3.65]; p=0.002) were independently associated with 5 year mortality.

Conclusion

Due to a high prevalence, chronic renal disease and cardiovascular disease are main prognostic factors for 5-year mortality among aged PLHIV.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, Reims Teaching Hospitals, Robert Debré Hospital, Reims, France

    Maxime Hentzien & F. Bani-Sadr

  2. Faculty of Medicine, University of Reims Champagne-Ardenne, EA 3797, Reims, France

    Maxime Hentzien & M. Dramé

  3. Department of Research and Innovation, Reims Teaching Hospitals, Robert Debré Hospital, Reims, France

    M. Dramé

  4. Infectious Diseases Department, University of Nantes, CHU Hôtel Dieu, Nantes, France

    C. Allavena

  5. Department of Infectious and Tropical Diseases, Clermont-Ferrand Teaching Hospitals, Gabriel-Montpied Hospital, Clermont-Ferrand, France

    C. Jacomet

  6. Department of Infectious and Tropical Diseases, Paris Teaching Hospitals, La Pitié-Salpêtrière Hospital, Paris, France

    M.-A. Valantin

  7. Department of Infectious and Tropical Diseases, Fort-De-France, Martinique Teaching Hospitals, Fort-De-France Hospital, Martinique, France

    A. Cabié

  8. Regional Coordination of HIV care and prevention, Toulouse University Hospital, Toulouse, France

    L. Cuzin

  9. Nouvel Hôpital Civil, HIV Care Center, Hôpitaux universitaires de Strasbourg, Strasbourg, France

    D. Rey

  10. Infectious Diseases Department, University of Nice, CHU L’Archet, Nice, France

    P. Pugliese

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  1. Maxime Hentzien
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  2. M. Dramé
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The Dat’AIDS Study Group

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Correspondence to Maxime Hentzien.

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Hentzien, M., Dramé, M., Allavena, C. et al. Impact of age-related comorbidities on five-year overall mortality among elderly HIV-infected patients in the late HAART era — Role of chronic renal disease. J Nutr Health Aging 20, 408–414 (2016). https://doi.org/10.1007/s12603-015-0608-7

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  • DOI: https://doi.org/10.1007/s12603-015-0608-7

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