Multimorbidity in elderly persons according to the year of diagnosis of human immunodeficiency virus infection : a cross-sectional dat’aids cohort study

2020

Article référencé dans le Web of Science WOS:000607829500018

Demontès M., Eymard-Duvernay Sabrina, Allavena C., Jovelin T., Reynes J., Hentzien M., Ravaux I., Delobel P., Bregigeon S., Rey D., Ferry T., Gagneux-Brunon A., Robineau O., Pugliese P., Duvivier C., Cabié A., Chirouze C., Jacomet C., Lamaury I., Merrien D., Hoen B., Hocqueloux L., Cheret A., Katlama C., Arvieux C., Krolak-Salmon P., Makinson A., Delaporte Eric, et al.

Clinical Infectious Diseases, 2020, [Publ. online 2019/12/09], art. ciz1171 [9 p.] ISSN 1058-4838

Background : We assessed prevalence of multimorbidity (MM) according to year of human immunodeficiency virus (HIV) diagnosis in elderly people living with HIV (PLWH). Methods : This was a cross-sectional study of MM in PLWH aged >-70 years from the Dat'AIDS French multicenter cohort. MM was defined as at least 3 coexistent morbidities of high blood pressure, diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardiovascular and cerebrovascular disease, obesity, undernutrition, or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV diagnosis (1983-1996, 1997-2006, and 2007-2018). The secondary analysis evaluated MM as a continuous outcome, and a sensitivity analysis excluded PLWH with nadir CD4 count <200 cells/ul. Results : Between January 2017 and September 2018, 2476 PLWH were included. Median age was 73 years, 75% were men, median CD4 count was 578 cells/ul, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, hepatitis C and hepatitis B virus coinfection, group of exposure, nadir CD4 count, CD4:CD8 ratio, and last CD4 level, calendar period of diagnosis was not associated with MM (P = .169). MM was associated with older age, CD4/CD8 ratio <0.8, and nadir CD4 count <200 cells/ul. Similar results were found with secondary and sensitivity analyses. Conclusions : MM prevalence was high and increased with age, low CD4/CD8 ratio, and nadir CD4 count <200 cells/ul but was not associated with calendar periods of HIV diagnosis. Known duration of HIV diagnosis does not seem to be a criterion for selecting elderly PLWH at risk of MM.

Sciences fondamentales / Techniques d'analyse et de recherche [020] ; Santé : généralités [050] ; Entomologie médicale / Parasitologie / Virologie [052]

Fonds IRD [F B010079204]

fdi:010079204