title: Co-morbidities in persons infected with HIV: increased burden with older age and negative effects on health-related quality of life.
abstract: This study sought to determine the synergistic effects of age and HIV infection on medical co-morbidity burden, along with its clinical correlates and impact on health-related quality of life (HRQoL) across the lifespan in HIV. Participants included 262 individuals across four groups stratified by age (≤40 and ≥50 years) and HIV serostatus. Medical co-morbidity burden was assessed using a modified version of the Charlson Co-morbidity Index (CCI). Multiple regression accounting for potentially confounding demographic, psychiatric, and medical factors revealed an interaction between age and HIV infection on the CCI, with the highest medical co-morbidity burden in the older HIV+cohort. Nearly half of the older HIV+group had at least one major medical co-morbidity, with the most prevalent being diabetes (17.8%), syndromic neurocognitive impairment (15.4%), and malignancy (12.2%). Affective distress and detectable plasma viral load were significantly associated with the CCI in the younger and older HIV-infected groups, respectively. Greater co-morbidity burden was uniquely associated with lower physical HRQoL across the lifespan. These findings highlight the prevalence and clinical impact of co-morbidities in older HIV-infected adults and underscore the importance of early detection and treatment efforts that might enhance HIV disease outcomes.
authors.affiliation: School of Medicine, University of Puerto Rico, San Juan, PR.
authors.forename: Alan T
authors.initials: AT
authors.lastname: Rodriguez-Penney
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Iudicello
authors.forename: Patricia K
authors.initials: PK
authors.lastname: Riggs
authors.forename: Katie
authors.initials: K
authors.lastname: Doyle
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Ellis
authors.forename: Scott L
authors.initials: SL
authors.lastname: Letendre
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
authors.forename: Steven Paul
authors.initials: SP
authors.lastname: Woods
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D002140:California / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D018434:Sickness Impact Profile; D012959:Socioeconomic Factors; D019562:Viral Load