title: 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.
abstract: OBJECTIVE
  To identify main prognostic factors for 5-year mortality among age-related comorbidities (ARCs) in older people living with HIV (PLHIV).
  
  
  METHODS
  A prospective, multicentre cohort study with a 5-year follow-up period in the late HAART era (from January 2008 to December 2012).
  
  
  METHODS
  The Dat'AIDS cohort involving 12 French hospitals.
  
  
  METHODS
  All actively followed HIV-1 infected patients aged 60 or older.
  
  
  METHODS
  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 patient-years). 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 < 200 cells/µl (aHR=2.23; 95%CI[1.36-3.65]; p=0.002) were independently associated with 5 year mortality.
  
  
  CONCLUSIONS
  Due to a high prevalence, chronic renal disease and cardiovascular disease are main prognostic factors for 5-year mortality among aged PLHIV.
authors.affiliation: Maxime Hentzien, Service de médecine interne, maladies infectieuses, immunologie Clinique, CHU Robert Debré, Avenue du général Koenig, 51092 Reims, France, Telephone number: (+33) 3 26 78 71 89, Fax number: (+33) 3 26 78 40 90, E-mail address: mhentzien@chu-reims.fr.
authors.forename: M
authors.initials: M
authors.lastname: Hentzien
authors.forename: M
authors.initials: M
authors.lastname: Dramé
authors.forename: C
authors.initials: C
authors.lastname: Allavena
authors.forename: C
authors.initials: C
authors.lastname: Jacomet
authors.forename: M-A
authors.initials: MA
authors.lastname: Valantin
authors.forename: A
authors.initials: A
authors.lastname: Cabié
authors.forename: L
authors.initials: L
authors.lastname: Cuzin
authors.forename: D
authors.initials: D
authors.lastname: Rey
authors.forename: P
authors.initials: P
authors.lastname: Pugliese
authors.forename: F
authors.initials: F
authors.lastname: Bani-Sadr
mesh_terms: D000368:Aged; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality; D005260:Female; D005355:Fibrosis / Q000453:epidemiology / Q000401:mortality; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality*; D006526:Hepatitis C / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000401:mortality
chemical_list: D019380:Anti-HIV Agents