title: Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults.
abstract: BACKGROUND
  Although it has been shown that human immunodeficiency virus (HIV)-infected adults are at greater risk for aging-associated events, it remains unclear as to whether these events happen at similar, or younger ages, in HIV-infected compared with uninfected adults. The objective of this study was to compare the median age at, and risk of, incident diagnosis of 3 age-associated diseases in HIV-infected and demographically similar uninfected adults.
  
  
  METHODS
  The study was nested in the clinical prospective Veterans Aging Cohort Study of HIV-infected and demographically matched uninfected veterans, from 1 April 2003 to 31 December 2010. The outcomes were validated diagnoses of myocardial infarction (MI), end-stage renal disease (ESRD), and non-AIDS-defining cancer (NADC). Differences in mean age at, and risk of, diagnosis by HIV status were estimated using multivariate linear regression models and Cox proportional hazards models, respectively.
  
  
  RESULTS
  A total of 98 687 (31% HIV-infected and 69% uninfected) adults contributed >450 000 person-years and 689 MI, 1135 ESRD, and 4179 NADC incident diagnoses. Mean age at MI (adjusted mean difference, -0.11; 95% confidence interval [CI], -.59 to .37 years) and NADC (adjusted mean difference, -0.10 [95% CI, -.30 to .10] years) did not differ by HIV status. HIV-infected adults were diagnosed with ESRD at an average age of 5.5 months younger than uninfected adults (adjusted mean difference, -0.46 [95% CI, -.86 to -.07] years). HIV-infected adults had a greater risk of all 3 outcomes compared with uninfected adults after accounting for important confounders.
  
  
  CONCLUSIONS
  HIV-infected adults had a higher risk of these age-associated events, but they occurred at similar ages than those without HIV.
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Keri N
authors.initials: KN
authors.lastname: Althoff
authors.affiliation: Veterans Affairs Pittsburgh Healthcare System, Pennsylvania.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: McGinnis
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Wyatt
authors.affiliation: Vanderbilt School of Medicine, Nashville, Tennessee.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Freiberg
authors.affiliation: Veterans Affairs Medical Center and George Washington University Medical Center, Washington D.C.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Gilbert
authors.affiliation: Salem Veterans Affairs Medical Center, Virginia University of Maryland School of Medicine, Baltimore.
authors.forename: Krisann K
authors.initials: KK
authors.lastname: Oursler
authors.affiliation: Atlanta Veterans Affairs Medical Center and Emory University School of Medicine, Georgia.
authors.forename: David
authors.initials: D
authors.lastname: Rimland
authors.affiliation: Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodriguez-Barradas
authors.affiliation: Veterans Affairs Connecticut Healthcare System and Yale Schools of Medicine and Public Health, New Haven, Connecticut.
authors.forename: Robert
authors.initials: R
authors.lastname: Dubrow
authors.affiliation: Veterans Affairs Connecticut Healthcare System and Yale Schools of Medicine and Public Health, New Haven, Connecticut.
authors.forename: Lesley S
authors.initials: LS
authors.lastname: Park
authors.affiliation: Veterans Affairs Connecticut Healthcare System and Yale Schools of Medicine and Public Health, New Haven, Connecticut.
authors.forename: Melissa
authors.initials: M
authors.lastname: Skanderson
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.
authors.forename: Meredith S
authors.initials: MS
authors.lastname: Shiels
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
authors.affiliation: Veterans Affairs Connecticut Healthcare System and Yale Schools of Medicine and Public Health, New Haven, Connecticut.
authors.forename: Amy C
authors.initials: AC
authors.lastname: Justice
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D000375:Aging; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D009369:Neoplasms / Q000175:diagnosis*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D014728:Veterans; D055815:Young Adult
keywords: HIV infection; aging; end-stage renal disease; myocardial infarction; non-AIDS-defining cancers