First Occurrence of Diabetes, Chronic Kidney Disease, and Hypertension Among North American HIV-Infected Adults, 2000-2013.
There remains concern regarding the occurrence of noncommunicable diseases (NCDs) among individuals aging with human immunodeficiency virus (HIV), but few studies have described whether disparities between demographic subgroups are present among individuals on antiretroviral therapy (ART) with access to care.



We assessed the first documented occurrence of type 2 diabetes mellitus (DM), chronic kidney disease (CKD), and treated hypertension (HTN) by age, sex, and race within the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). HIV-infected adults (≥18 years) who initiated ART were observed for first NCD occurrence between 1 January 2000 and 31 December 2013. Cumulative incidences as of age 70 were estimated accounting for the competing risk of death; Poisson regression was used to compare rates of NCD occurrence by demographic subgroup.



We included >50000 persons with >250000 person-years of follow-up. Median follow-up was 4.7 (interquartile range, 2.4–8.1) years. Rates of first occurrence (per 100 person-years) were 1.2 for DM, 0.6 for CKD, and 2.6 for HTN. Relative to non-black women, the cumulative incidences were increased in black women (68% vs 51% for HTN, 52% vs 41% for DM, and 38% vs 35% for CKD; all P < .001); this disparity was also found among men (73% vs 60% for HTN, 44% vs 34% for DM, and 30% vs 25% for CKD; all P < .001).



Racial disparities in the occurrence of DM, CKD, and HTN emphasize the need for prevention and treatment options for these HIV populations receiving care in North America.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Cherise
C
Wong
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Stephen J
SJ
Gange
Centers for Disease Control and Prevention, Atlanta, Georgia.
Kate
K
Buchacz
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Richard D
RD
Moore
Veterans Affairs Connecticut Healthcare System, West Haven.
Amy C
AC
Justice
Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, Rockville, Maryland.
Michael A
MA
Horberg
University of Calgary, Alberta, Canada.
M John
MJ
Gill
Vanderbilt University, Nashville, Tennessee.
John R
JR
Koethe
Vanderbilt University, Nashville, Tennessee.
Peter F
PF
Rebeiro
Kaiser Permanente Division of Research, Kaiser Permanente Northern California, Oakland.
Michael J
MJ
Silverberg
Northwestern University, Chicago, Illinois.
Frank J
FJ
Palella
Centers for Disease Control and Prevention, Atlanta, Georgia.
Pragna
P
Patel
University of Washington, Seattle.
Mari M
MM
Kitahata
University of Washington, Seattle.
Heidi M
HM
Crane
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Alison G
AG
Abraham
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Hasina
H
Samji
University of North Carolina at Chapel Hill.
Sonia
S
Napravnik
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada.
Tareq
T
Ahmed
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Jennifer E
JE
Thorne
Harvard School of Public Health, Boston, Massachusetts.
Ronald J
RJ
Bosch
Universidad Central del Caribe, Bayamon, Puerto Rico.
Angel M
AM
Mayor
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Keri N
KN
Althoff
D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology* / Q000266:history; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000266:history; D049674:History, 21st Century; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology* / Q000266:history; D008297:Male; D008875:Middle Aged; D009656:North America / Q000453:epidemiology; D063868:Patient Outcome Assessment; D011159:Population Surveillance; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology* / Q000266:history; D012307:Risk Factors