Co-Morbidities in Persons Infected with HIV: Increased Burden with Older Age and Negative Effects on Health-Related Quality of Life

被引:253
作者
Rodriguez-Penney, Alan T. [1 ]
Iudicello, Jennifer E. [2 ]
Riggs, Patricia K. [2 ]
Doyle, Katie [2 ]
Ellis, Ronald J. [3 ]
Letendre, Scott L. [4 ]
Grant, Igor [2 ]
Woods, Steven Paul
机构
[1] Univ Puerto Rico, Sch Med, San Juan, PR 00936 USA
[2] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA
[3] Univ Calif San Diego, Dept Neurosci, San Diego, CA 92103 USA
[4] Univ Calif San Diego, Dept Med, San Diego, CA 92103 USA
基金
美国国家卫生研究院;
关键词
ACTIVE ANTIRETROVIRAL THERAPY; NEUROCOGNITIVE IMPAIRMENT; MEDICAL COMORBIDITIES; RISK; IMPACT; INDIVIDUALS; MORTALITY; DISEASE; ADULTS; DEATH;
D O I
10.1089/apc.2012.0329
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
This study sought to determine the synergistic effects of age and HIV infection on medical co-morbidity burden, along with its clinical correlates and impact on health-related quality of life (HRQoL) across the lifespan in HIV. Participants included 262 individuals across four groups stratified by age (<= 40 and 50 years) and HIV serostatus. Medical co-morbidity burden was assessed using a modified version of the Charlson Co-morbidity Index (CCI). Multiple regression accounting for potentially confounding demographic, psychiatric, and medical factors revealed an interaction between age and HIV infection on the CCI, with the highest medical co-morbidity burden in the older HIV + cohort. Nearly half of the older HIV + group had at least one major medical co-morbidity, with the most prevalent being diabetes (17.8%), syndromic neurocognitive impairment (15.4%), and malignancy (12.2%). Affective distress and detectable plasma viral load were significantly associated with the CCI in the younger and older HIV-infected groups, respectively. Greater co-morbidity burden was uniquely associated with lower physical HRQoL across the lifespan. These findings highlight the prevalence and clinical impact of co-morbidities in older HIV-infected adults and underscore the importance of early detection and treatment efforts that might enhance HIV disease outcomes.
引用
收藏
页码:5 / 16
页数:12
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