| |
Incidence of non-AIDS defining comorbidities among young adults with perinatally-acquired HIV in North America, 2000-2019
|
| |
| |
Download the PDF
Haw, Nel Jason L.a; Lesko, Catherine R.a; Ng, Derek K.a; Lam, Jenniferb; Lang, Raynellc; Kitahata, Mari M.d; Crane, Heidid; Eron, Joseph Jr.e; Gill, M. Johnc,f; Horberg, Michael A.g; Karris, Maileh; Loutfy, Monai,j; Mcginnis, Kathleen A.k; Moore, Richard D.l; Althoff, Keria; Agwu, Allisonl,m; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)∗
"high incidence of five chronic comorbidities among people with PHIV. Earlier screening at younger ages might be considered for this unique population to strengthen prevention strategies and initiate treatment in a timely way.”
Our results suggest that by age 30, about one in five people with PHIV have T2DM, two in five have hypercholesterolemia, one in two have hypertriglyceridemia, one in four have hypertension, and one in four have CKD. We also found that about one in five have already developed hypercholesterolemia and hypertriglyceridemia before they transitioned into adult HIV care. Across sex at birth and self-identified race, non-Black females had the highest incidence of hypercholesterolemia and hypertriglyceridemia, Black adults with PHIV had the highest incidence of hypertension, and Black males had the highest incidence of CKD.
Abstract
Objective:
To describe the incidence of diabetes mellitus type 2 (T2DM), hypercholesterolemia, hypertriglyceridemia, hypertension, and chronic kidney disease (CKD) from 2000 to 2019 among North American adults with perinatally-acquired HIV (PHIV) aged 18 to 30
Design:
Description of outcomes based on electronic health records for a cohort of 375 young adults with PHIV enrolled in routine HIV care at clinics contributing data to the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)
Methods:
We estimated overall, sex-, and race-stratified cumulative incidences using Turnbull estimation, and incidence rates using quasi-Poisson regression. T2DM was defined as glycosylated hemoglobin >6.5% or based on clinical diagnosis and medication use. Hypercholesterolemia was based on medication use or total cholesterol ≥200 mg/dL. Hypertriglyceridemia was based on medication use or fasting triglyceride ≥150 mg/dL or non-fasting ≥200 mg/dL. Hypertension was based on clinical diagnosis. CKD was defined as estimated glomerular filtration rates <90 ml/mi|1.73 m2 for ≥3 months.
Results:
Cumulative incidence by age 30 and incidence rates from age 18 to 30 (per 100 person-years) were: T2DM: 19%, 2.9; hypercholesterolemia: 40%, 4.6; hypertriglyceridemia: 50%, 5.6; hypertension: 22%, 2.0; and CKD: 25%, 3.3. Non-Black females had the highest incidence of hypercholesterolemia and hypertriglyceridemia, Black adults had the highest hypertension incidence, and Black males had the highest CKD incidence.
Conclusion:
There was a high incidence of five chronic comorbidities among people with PHIV. Earlier screening at younger ages might be considered for this unique population to strengthen prevention strategies and initiate treatment in a timely way.
|
|
| |
| |
|
|
|
