title: Premature age-related comorbidities among HIV-infected persons compared with the general population.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV)-infected patients may have a greater risk of noninfectious comorbidities (NICMs) compared with the general population. We assessed the prevalence and risk factors for NICMs in a large cohort of HIV-infected adults and compared these findings with data from matched control subjects.
  
  
  METHODS
  We performed a case-control study involving antiretroviral therapy (ART)-experienced HIV-infected patients treated at Modena University, Italy, from 2002 through 2009. These patients were compared with age-, sex-, and race-matched adults (control subjects) from the general population included in the CINECA ARNO database. NICMs included cardiovascular disease, hypertension, diabetes mellitus, bone fractures, and renal failure. Polypathology (Pp) was defined as the concurrent presence of ≥2 NICMs. Logistic regression models were constructed to evaluate associated predictors of NICMs and Pp.
  
  
  RESULTS
  There were 2854 patients and 8562 control subjects. The mean age was 46 years, and 37% were women. Individual NICM and Pp prevalences in each age stratum were higher among patients than among controls (all P <.001). Pp prevalence among patients aged 41-50 years was similar to that among controls aged 51-60 years (P value was not statistically significant); diabetes mellitus, cardiovascular disease, bone fractures, and renal failure were statistically independent after adjustment for sex, age, and hypertension. Logistic regression models showed that independent predictors of Pp in the overall cohort were (all P < .001) age (odds ratio [OR], 1.11), male sex (OR, 1.77), nadir CD4 cell count <200 cells/μL (OR, 4.46), and ART exposure (OR, 1.01).
  
  
  CONCLUSIONS
  Specific age-related NICMs and Pp were more common among HIV-infected patients than in the general population. The prevalence of Pp in HIV-infected persons anticipated Pp prevalence observed in the general population among persons who were 10 years older, and HIV-specific cofactors (lower nadir CD4 cell count and more prolonged ART exposure) were identified as risk factors. These data support the need for earlier screening for NICMs in HIV-infected patients.
authors: Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Italy.
authors: Giovanni
authors: G
authors: Guaraldi
authors: Gabriella
authors: G
authors: Orlando
authors: Stefano
authors: S
authors: Zona
authors: Marianna
authors: M
authors: Menozzi
authors: Federica
authors: F
authors: Carli
authors: Elisa
authors: E
authors: Garlassi
authors: Alessandra
authors: A
authors: Berti
authors: Elisa
authors: E
authors: Rossi
authors: Alberto
authors: A
authors: Roverato
authors: Frank
authors: F
authors: Palella
mesh_terms: D000328:Adult; D000367:Age Factors; D019380:Anti-HIV Agents / Q000008:administration & dosage; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051437:Renal Insufficiency / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D019380:Anti-HIV Agents