title: Major health impact of accelerated aging in young HIV-infected individuals on antiretroviral therapy.
abstract: Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls.
  
  
  
  HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community. All participants were aged at least 25 years of age with no acute illness, and HIV-infected individuals were on stable ART. Geriatric conditions were assessed and the burden scored as a composite of geriatric conditions present in an individual (total score = 10). Multivariate regression analysis was performed to determine the risk factors and health impact associated with the burden of geriatric conditions.
  
  
  
  We analyzed data from 336 HIV-infected individuals (total HIV+), of whom 172 were matched for age, sex, and ethnicity with 172 HIV-uninfected controls (matched subset). In the total HIV-positive cohort, median (interquartile range) age was 44 (38-51) years and CD4 T-cell count was 562 (398-737) cells/μl. The burden of geriatric conditions was significantly higher in the HIV-infected group compared with controls (P < 0.001). With an increasing geriatric condition burden, quality-of-life scores were 2.2-times poorer, healthcare use five times greater, and mortality risk scores four times higher in the HIV-infected group compared with matched controls. Both sociobehavioural and HIV-related clinical factors were independently associated with an increasing burden of geriatric condition in HIV.
  
  
  
  A high burden of geriatric conditions with significant impact on health outcomes, including mortality risk scores are observed among HIV-infected individuals on ART in a resource-limited setting.
authors.affiliation: aCentre of Excellence for Research in AIDS bDepartment of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia cThe Peter Doherty Institute for Infection and Immunity, The University of Melbourne dInfectious Diseases Unit, Department of Medicine, Faculty of Medicine eDepartment of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia fDepartment of Infectious Diseases, Monash University and Alfred Hospital, Melbourne gRoyal Melbourne Hospital, Melbourne, Australia hGeriatric Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Reena
authors.initials: R
authors.lastname: Rajasuriar
authors.forename: Meng L
authors.initials: ML
authors.lastname: Chong
authors.forename: Nor S
authors.initials: NS
authors.lastname: Ahmad Bashah
authors.forename: Siti A
authors.initials: SA
authors.lastname: Abdul Aziz
authors.forename: Megan
authors.initials: M
authors.lastname: Mcstea
authors.forename: Erica C Y
authors.initials: ECY
authors.lastname: Lee
authors.forename: Pui L
authors.initials: PL
authors.lastname: Wong
authors.forename: Iskandar
authors.initials: I
authors.lastname: Azwa
authors.forename: Sharifah F
authors.initials: SF
authors.lastname: Syed Omar
authors.forename: Pauline S M
authors.initials: PSM
authors.lastname: Lai
authors.forename: Sasheela
authors.initials: S
authors.lastname: Ponampalavanar
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Crowe
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Lewin
authors.forename: Shahrul B
authors.initials: SB
authors.lastname: Kamaruzzaman
authors.forename: Adeeba
authors.initials: A
authors.lastname: Kamarulzaman
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D019588:Aging, Premature / Q000453:epidemiology* / Q000473:pathology*; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
chemical_list: D044966:Anti-Retroviral Agents