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Kanazawa A, Yan Y, Yuda M, Fukui N, Saita M, Mori H, Naito T. Risk factors for progressing to severe COVID-19 among people living with HIV in Japan: A hospital claims database study. J Infect Chemother 2024; 30:40-47. [PMID: 37708941 DOI: 10.1016/j.jiac.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 08/27/2023] [Accepted: 09/10/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Risk factors for severe COVID-19 associated with people living with HIV (PLWH) have not been well studied in Japan. In this study, we aim to reveal how having AIDS and comorbidities affect adverse COVID-19 outcomes. METHODS This observational, retrospective study examined the clinical outcomes for PLWH hospitalized as COVID-19 inpatients in Japan, using data extracted from hospitals with the Diagnosis Procedure Combination (DPC) system between January 2020 and December 2021. From 4672 records of HIV patients receiving antiretroviral therapy, 85 adult PLWH became hospitalized with COVID-19. The associations between patients' AIDS diagnosis, comorbidities, and their adverse COVID-19 outcomes (mild/moderate and severe/death) were analyzed. RESULTS Among 85 studied patients, 78 were male (91.8%) with mean (SD) age of 48 (14.4) years. 75 (88.2%) were found to be COVID-19 mild/moderate; 9 (10.6%) were severe; 1 (1.2%) died. Older age (p = 0.002) and hypertension (p = 0.032) were significantly associated with progressing to severe COVID-19 or death. AIDS and other AIDS-defining illnesses were not found to be significant risk factors in this study. CONCLUSIONS While interpretation of the results from this hospital claim database study warrants caution, we found that among PLWH hospitalized as COVID-19 inpatients in Japan, those who are older or with hypertension have a higher risk for progression to severe COVID-19 outcomes, suggesting a careful monitoring of clinical course for these patients.
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Affiliation(s)
- Akio Kanazawa
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Yan Yan
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Mayumi Yuda
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Fukui
- Center for Promotion of Data Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mizue Saita
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Hirotake Mori
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Toshio Naito
- Department of General Medicine, Juntendo University Faculty of Medicine, Tokyo, Japan.
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Moreno E, Martínez-Sanz J, Martín-Mateos R, Díaz-Álvarez J, Serrano-Villar S, Burgos-Santamaría D, Luna L, Vivancos MJ, Moreno-Zamora A, Pérez-Elías MJ, Moreno S, Dronda F, Montes ML, Sánchez-Conde M. Global DNA methylation and telomere length as markers of accelerated aging in people living with HIV and non-alcoholic fatty liver disease. BMC Genomics 2023; 24:567. [PMID: 37741970 PMCID: PMC10517540 DOI: 10.1186/s12864-023-09653-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/05/2023] [Indexed: 09/25/2023] Open
Abstract
Metabolic-dysfunction-associated fatty liver disease (MAFLD) is a comorbidity that generally increases in people living with HIV (PLWH). This condition is usually accompanied by persistent inflammation and premature immune system aging. In this prospective cohort study, we describe a straightforward methodology for quantifying biomarkers of aging, such as DNA methylation and telomere length, in PLWH and in the context of another relevant condition, such as MAFLD. Fifty-seven samples in total, thirty-eight from PLWH and nineteen from non-PLWH participants with or without MAFLD, were obtained and subjected to DNA extraction from peripheral blood mononuclear cells (PBMCs). Global DNA methylation and telomere length quantification were performed using an adapted enzyme-linked immunosorbent assay (ELISA) and qPCR, respectively. The quantification results were analysed and corrected by clinically relevant variables in this context, such as age, sex, and metabolic syndrome. Our results show an increased association of these biomarkers in PLWH regardless of their MAFLD status. Thus, we propose including the quantification of these age-related factors in studies of comorbidities. This will allow a better understanding of the effect of comorbidities of HIV infection and MAFLD and prevent their effects in these populations in the future.
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Affiliation(s)
- Elena Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - Javier Martínez-Sanz
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Rosa Martín-Mateos
- Department of Gastroenterology and Hepatology, Metabolic Liver Disease Clinic, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- Universidad de Alcalá, 28871, Madrid, Spain
| | - Jorge Díaz-Álvarez
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Sergio Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Diego Burgos-Santamaría
- Department of Gastroenterology and Hepatology, Metabolic Liver Disease Clinic, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
| | - Laura Luna
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Jesús Vivancos
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Ana Moreno-Zamora
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Jesús Pérez-Elías
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Santiago Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Universidad de Alcalá, 28871, Madrid, Spain
| | - Fernando Dronda
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - María Luisa Montes
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain
- Internal Medicine Service, Hospital Universitario La Paz. IdiPAZ, 28046, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Hospital Universitario Ramón Y Cajal, Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain.
- CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Sánchez-Conde M, Alba C, Castro I, Dronda F, Ramírez M, Arroyo R, Moreno S, Rodríguez JM, Brañas F. Comparison of the Fecal Bacteriome of HIV-Positive and HIV-Negative Older Adults. Biomedicines 2023; 11:2305. [PMID: 37626801 PMCID: PMC10452058 DOI: 10.3390/biomedicines11082305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
HIV infection is considered a scenario of accelerated aging. Previous studies have suggested a link between aging, frailty, and gut dysbiosis, but there is a knowledge gap regarding the HIV population. Our objective was to compare the fecal bacteriome of older people with HIV (PWH) and non-HIV controls, and to assess potential links between gut dysbiosis and frailty. A total of 36 fecal samples (24 from PWH and 12 from non-HIV controls) were submitted to a metataxonomic analysis targeting the V3-V4 hypervariable region of the 16S rRNA gene. High-quality reads were assembled and classified into operational taxonomic units. Alpha diversity, assessed using the Shannon index, was higher in the control group than in the HIV group (p < 0.05). The relative abundance of the genus Blautia was higher in the HIV group (p < 0.001). The presence of Blautia was also higher in PWH with depression (p = 0.004), whereas the opposite was observed for the genus Bifidobacterium (p = 0.004). Our study shows shifts in the composition of the PWH bacteriome when compared to that of healthy controls. To our knowledge, this is the first study suggesting a potential link between depression and gut dysbiosis in the HIV population.
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Affiliation(s)
- Matilde Sánchez-Conde
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (F.D.); (S.M.)
- CIBER de Enfermedades Infecciosas (CIBERINFECT), Instituto de Salud Carlos III, 28220 Madrid, Spain
| | - Claudio Alba
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (C.A.); (I.C.); (J.M.R.)
| | - Irma Castro
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (C.A.); (I.C.); (J.M.R.)
| | - Fernando Dronda
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (F.D.); (S.M.)
| | - Margarita Ramírez
- Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain;
| | - Rebeca Arroyo
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (C.A.); (I.C.); (J.M.R.)
| | - Santiago Moreno
- Infectious Diseases Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (F.D.); (S.M.)
| | - Juan Miguel Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (C.A.); (I.C.); (J.M.R.)
| | - Fátima Brañas
- Geriatric Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
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Premeaux TA, Ndhlovu LC. Decrypting biological hallmarks of aging in people with HIV. Curr Opin HIV AIDS 2023:01222929-990000000-00054. [PMID: 37421383 DOI: 10.1097/coh.0000000000000810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
PURPOSE OF REVIEW HIV infection adds further complexity to the heterogenous process of aging. In this focused review, we examine and discuss recent advances to better elucidate mechanisms of biological aging perturbed and accelerated in the context of HIV, particularly among those with viral suppression through the benefits of antiretroviral therapy (ART). New hypotheses from these studies are poised to provide an improved understanding of multifaceted pathways that converge and likely form the basis for effective interventions toward successful aging. RECENT FINDINGS Evidence to date suggests multiple mechanisms of biological aging impact people living with HIV (PLWH). Recent literature delves and expands on how epigenetic alterations, telomere attrition, mitochondrial perturbations, and intercellular communications may underpin accelerated or accentuated aging phenotypes and the disproportionate prevalence of age-related complications among PLWH. Although most hallmarks of aging are likely exacerbated in the setting of HIV, ongoing research efforts are providing new insight on the collective impact these conserved pathways may have in the aging disease processes. SUMMARY New knowledge on underlying molecular disease mechanisms impacting people aging with HIV are reviewed. Also examined are studies that may facilitate the development and implementation of effective therapeutics and guidance on improving geriatric HIV clinical care.
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Affiliation(s)
- Thomas A Premeaux
- Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York, USA
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Han WM, Apornpong T, Gatechompol S, Ubolyam S, Chattranukulchai P, Wattanachanya L, Siwamogsatham S, Kerr SJ, Erlandson KM, Avihingsanon A. Association of Phenotypic Aging Marker with comorbidities, frailty and inflammatory markers in people living with HIV. BMC Geriatr 2022; 22:1010. [PMID: 36585655 PMCID: PMC9805022 DOI: 10.1186/s12877-022-03720-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Aging characteristics in people living with HIV (PLWH) are heterogeneous, and the identification of risk factors associated with aging-related comorbidities such as neurocognitive impairment (NCI) and frailty is important. We evaluated predictors of novel aging markers, phenotypic age (PhenoAge) and phenotypic age acceleration (PAA) and their association with comorbidities, frailty, and NCI. METHODS In a cohort of PLWH and age- and sex-matched HIV-negative controls, we calculated PhenoAge using chronological age and 9 biomarkers from complete blood counts, inflammatory, metabolic-, liver- and kidney-related parameters. PAA was calculated as the difference between chronological age and PhenoAge. Multivariate logistic regression models were used to identify the factors associated with higher (>median) PAA. Area under the receiver operating characteristics curve (AUROC) was used to assess model discrimination for frailty. RESULTS Among 333 PLWH and 102 HIV-negative controls (38% female), the median phenotypic age (49.4 vs. 48.5 years, p = 0.54) and PAA (- 6.7 vs. -7.5, p = 0.24) was slightly higher and PAA slightly less in PLWH although this did not reach statistical significance. In multivariate analysis, male sex (adjusted odds ratio = 1.68 [95%CI = 1.03-2.73]), current smoking (2.74 [1.30-5.79]), diabetes mellitus (2.97 [1.48-5.99]), hypertension (1.67 [1.02-2.72]), frailty (3.82 [1.33-10.93]), and higher IL-6 levels (1.09 [1.04-1.15]), but not HIV status and NCI, were independently associated with higher PAA. PhenoAge marker discriminated frailty better than chronological age alone (AUROC: 0.75 [0.66-0.85] vs. 0.65 [0.55-0.77], p = 0.04). In the analysis restricted to PLWH, PhenoAge alone predicted frailty better than chronological age alone (AUROC: 0.7412 vs. 0.6499, P = 0.09) and VACS index (AUROC: 0.7412 vs. 0.6811, P = 0.34) despite not statistically significant. CONCLUSIONS While PLWH did not appear to have accelerated aging in our cohort, the phenotypic aging marker was significantly associated with systemic inflammation, frailty, and cardiovascular disease risk factors. This simple aging marker could be useful to identify high-risk PLWH within a similar chronological age group.
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Affiliation(s)
- Win Min Han
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Tanakorn Apornpong
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | - Sivaporn Gatechompol
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sasiwimol Ubolyam
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pairoj Chattranukulchai
- grid.7922.e0000 0001 0244 7875Division of Cardiovascular Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Lalita Wattanachanya
- grid.7922.e0000 0001 0244 7875Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.411628.80000 0000 9758 8584Excellence Center for Diabetes, Hormone, and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sarawut Siwamogsatham
- grid.7922.e0000 0001 0244 7875Division of Ambulatory and Hospital Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Chula Clinical Research Center, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Stephen J. Kerr
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand ,grid.1005.40000 0004 4902 0432Kirby Institute, UNSW Sydney, Sydney, Australia ,grid.7922.e0000 0001 0244 7875Biostatistics Excellence Centre, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kristine M. Erlandson
- grid.430503.10000 0001 0703 675XDivision of Infectious Diseases, School of Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO USA
| | - Anchalee Avihingsanon
- grid.419934.20000 0001 1018 2627The HIV Netherlands Australia Thailand Research Collaboration (HIV-NAT), Thai Red Cross AIDS Research Centre, Bangkok, Thailand ,grid.7922.e0000 0001 0244 7875Centre of Excellence in Tuberculosis, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Liu S, Yan Q, Jiang Y, Xiao M, Zhao J, Wang Y, Deng R, Wang C, Yang Z. The Impact of Frailty on All-Cause Mortality in Patients with HIV Infection: A Systematic Review and Meta-Analysis. AIDS Res Hum Retroviruses 2022; 38:692-699. [PMID: 35658605 DOI: 10.1089/aid.2021.0155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The aim of this study was to conduct a systematic review and meta-analysis of cohort studies that have examined the association between frailty and all-cause mortality in patients with HIV infection. We searched Embase, Medline through the Ovid interface, PubMed, Cochrane Library, and Web of Science to identify potential studies. Cohort studies of death outcomes in HIV patients under debilitating conditions were included and other ineligible or inadequate data were excluded. Data related to all-cause mortality in patients with HIV were extracted. The quality of the included studies was assessed using the Newcastle-Ottawa Scale for cohort studies. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were pooled to estimate the association between frailty and all-cause mortality using Stata, version 12.0. We identified 845 unduplicated citations. Of these, six cohort studies were eligible for inclusion in the review after applying our inclusion and exclusion criteria. Pooled results demonstrated that patients with HIV experiencing frailty were at an increased risk of all-cause mortality (pooled HR = 2.69, 95% CI = 1.83-3.97, p < .001) compared with those without frailty. Frailty was significantly associated with an increased risk of all-cause mortality among patients with HIV, indicating that frailty is an important predictor of adverse clinical outcomes. Therefore, more attention should be paid to screen patients with HIV for frailty and adopt appropriate interventions and personalized treatment plans to prevent the occurrence of adverse events. However, these results need to be validated in further prospective cohort studies in ethnically or geographically diverse populations.
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Affiliation(s)
- Shanshan Liu
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Qiao Yan
- Clinical Trial Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Yan Jiang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Mengmeng Xiao
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Jing Zhao
- Center of Infectious Diseases, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Ying Wang
- Center of Infectious Diseases, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Rong Deng
- Center of Infectious Diseases, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Cong Wang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Zhibo Yang
- Evidence-based Nursing Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
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Different profiles among older adults with HIV according to their chronological age and the year of HIV diagnosis: The FUNCFRAIL cohort study (GeSIDA 9817). PLoS One 2022; 17:e0266191. [PMID: 35353855 PMCID: PMC8967027 DOI: 10.1371/journal.pone.0266191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/15/2022] [Indexed: 01/08/2023] Open
Abstract
Background People in their fifties with HIV are considered older adults, but they appear not to be a homogeneous group. Objective To evaluate the differences among older adults with HIV according to their chronological age and the year of HIV diagnosis. Methods Cross-sectional study of the FUNCFRAIL cohort. Patients 50 or over with HIV were included and were stratified by both chronological age and the year of HIV diagnosis: before 1996 (long-term HIV survivors [LTHS]) and after 1996. We recorded sociodemographic data, HIV-related factors, comorbidities, frailty, physical function, other geriatric syndromes, and quality of life (QOL). Results We evaluated 801 patients. Of these, 24.7% were women, 47.0% were LTHS, and 14.7% were 65 or over. Of the 65 or over patients, 73% were diagnosed after 1996. Higher rates of comorbidities among LTHS were found, being the more prevalent: COPD, history of cancer, osteoarthritis, depression, and other psychiatric disorders while the more prevalent among the 65 or over patients were: hypertension, diabetes, dyslipidemia, cancer, and osteoarthritis. LTHS showed a significantly worse QOL. There were no differences by the year of HIV diagnosis regarding frailty and functional impairment (SPPB <10) but they were more than twice as prevalent in the 65 or over patients compared to the other chronological age groups. Conclusions A LTHS and a 65 or over person are both “older adults with HIV,” but their characteristics and requirements differ markedly. It is mandatory to design specific approaches focused on the real needs of the different profiles.
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Rodés B, Cadiñanos J, Esteban-Cantos A, Rodríguez-Centeno J, Arribas JR. Ageing with HIV: Challenges and biomarkers. EBioMedicine 2022; 77:103896. [PMID: 35228014 PMCID: PMC8889090 DOI: 10.1016/j.ebiom.2022.103896] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/13/2022] Open
Abstract
The antiretroviral treatment (ART) developed to control HIV infection led to a revolution in the prognosis of people living with HIV (PLWH). PLWH underwent from suffering severe disease and often fatal complications at young ages to having a chronic condition and a life expectancy close to the general population. Nevertheless, chronic age-related diseases increase as PLWH age. The harmful effect of HIV infection on the individual's immune system adds to its deterioration during ageing, exacerbating comorbidities. In addition, PLWH are more exposed to risk factors affecting ageing, such as coinfections or harmful lifestyles. The ART initiation reverses the biological ageing process but only partially, and additionally can have some toxicities that influence ageing. Observational studies suggest premature ageing in PLWH. Therefore, there is considerable interest in the early prediction of unhealthy ageing through validated biomarkers, easy to implement in HIV-clinical settings. The most promising biomarkers are second-generation epigenetic clocks and integrative algorithms.
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Affiliation(s)
- Berta Rodés
- HIV/AIDS and Infectious Diseases Research Group, Hospital Universitario La Paz Institute for Health Research-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, Spain; CIBER of Infectious Diseases (CIBER-INFECT), 28029 Madrid, Spain.
| | - Julen Cadiñanos
- HIV/AIDS and Infectious Diseases Research Group, Hospital Universitario La Paz Institute for Health Research-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, Spain; Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain; CIBER of Infectious Diseases (CIBER-INFECT), 28029 Madrid, Spain
| | - Andrés Esteban-Cantos
- HIV/AIDS and Infectious Diseases Research Group, Hospital Universitario La Paz Institute for Health Research-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, Spain; CIBER of Infectious Diseases (CIBER-INFECT), 28029 Madrid, Spain
| | - Javier Rodríguez-Centeno
- HIV/AIDS and Infectious Diseases Research Group, Hospital Universitario La Paz Institute for Health Research-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, Spain; CIBER of Infectious Diseases (CIBER-INFECT), 28029 Madrid, Spain
| | - José Ramón Arribas
- HIV/AIDS and Infectious Diseases Research Group, Hospital Universitario La Paz Institute for Health Research-IdiPAZ, Paseo de la Castellana 261, Madrid 28046, Spain; Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitario La Paz, Paseo de la Castellana 261, Madrid 28046, Spain; CIBER of Infectious Diseases (CIBER-INFECT), 28029 Madrid, Spain.
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Shiau S, Arpadi SM, Shen Y, Cantos A, Ramon CV, Shah J, Jang G, Manly JJ, Brickman AM, Baccarelli AA, Yin MT. Epigenetic Aging Biomarkers Associated With Cognitive Impairment in Older African American Adults With Human Immunodeficiency Virus (HIV). Clin Infect Dis 2021; 73:1982-1991. [PMID: 34143869 PMCID: PMC8664485 DOI: 10.1093/cid/ciab563] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Accelerated epigenetic aging using DNA methylation (DNAm)-based biomarkers has been reported in people with human immunodeficiency virus (HIV, PWH), but limited data are available among African Americans (AA), women, and older PWH. METHODS DNAm was measured using Illumina EPIC Arrays for 107 (69 PWH and 38 HIV-seronegative controls) AA adults ≥60 years in New York City. Six DNAm-based biomarkers of aging were estimated: (1) epigenetic age acceleration (EAA), (2) extrinsic epigenetic age acceleration (EEAA), (3) intrinsic epigenetic age acceleration (IEAA), (4) GrimAge, (5) PhenoAge, and (6) DNAm-estimated telomere length (DNAm-TL). The National Institutes of Health (NIH) Toolbox Cognition Battery (domains: executive function, attention, working memory, processing speed, and language) and Montreal Cognitive Assessment (MoCA) were administered. Participants were assessed for frailty by the Fried criteria. RESULTS The PWH and control groups did not differ by sex, chronological age, or ethnicity. In total, 83% of PWH had a viral load <50 copies/mL, and 94% had a recent CD4 ≥200 cells/µL. The PWH group had a higher EAA, EEAA, GrimAge, and PhenoAge, and a lower DNAm-TL compared to the controls. IEAA was not different between groups. For PWH, there were significant negative correlations between IEAA and executive function, attention, and working memory and PhenoAge and attention. No associations between biomarkers and frailty were detected. CONCLUSIONS Evidence of epigenetic age acceleration was observed in AA older PWH using DNAm-based biomarkers of aging. There was no evidence of age acceleration independent of cell type National Institutes of Health composition (IEAA) associated with HIV, but this measure was associated with decreased cognitive function among PWH.
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Affiliation(s)
- Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey, USA
| | - Stephen M Arpadi
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Department of Pediatrics, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- ICAP at Columbia, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Yanhan Shen
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Anyelina Cantos
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Christian Vivar Ramon
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Jayesh Shah
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Grace Jang
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Jennifer J Manly
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Adam M Brickman
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| | - Michael T Yin
- Department of Medicine, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
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10
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Esteban-Cantos A, Montejano R, Rodríguez-Centeno J, Saiz-Medrano G, De Miguel R, Barruz P, Bernardino JI, Mena-Garay B, Cadiñanos J, Jiménez-González M, Nevado J, Valencia E, Mayoral-Muñoz M, Arribas JR, Rodés B. Longitudinal changes in epigenetic age acceleration in aviremic HIV-infected recipients of long-term antiretroviral treatment. J Infect Dis 2021; 225:287-294. [PMID: 34166509 DOI: 10.1093/infdis/jiab338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 06/22/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND HIV infection induces epigenetic age acceleration (EAA), but it remains unclear whether epigenetic aging continues to accelerate during successful ART and prolonged virological suppression. METHODS We longitudinally analyzed 63 long-term aviremic HIV-infected adults. Using blood DNA methylation patterns, we calculated EAA measures based on three epigenetic clocks (Horvath´s clock, PhenoAge and GrimAge). We recorded the emergence of serious AIDS-related and non-AIDS-related events throughout the study to assess its association with EAA. RESULTS All participants were on stable ART and were virologically suppressed. After 4 years of follow-up, PhenoAge-EAA and GrimAge-EAA showed no differences, whereas Horvath-EAA slightly decreased (median difference; -0.53 years, p=0.015). Longitudinal changes in EAA measures were independent of changes in CD4 counts, the antiretroviral regimen or other HIV related factors. 19% of participants experienced a serious clinical event during the study. Horvath-EAA was significantly higher at baseline in participants with clinical events (p=0.027). After adjusting for confounders, we found a trend towards an association of higher levels of all EAA measures at baseline with serious clinical events. CONCLUSIONS Epigenetic aging did not accelerate in long-term aviremic HIV-infected adults after four years of successful ART. EAA measures deserve further study as potential tools for predicting clinical events.
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Affiliation(s)
- Andrés Esteban-Cantos
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Rocio Montejano
- Infectious Diseases Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Javier Rodríguez-Centeno
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Gabriel Saiz-Medrano
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Rosa De Miguel
- Infectious Diseases Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Pilar Barruz
- Genomics Laboratory, INGEMM, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Jose I Bernardino
- HIV Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Beatriz Mena-Garay
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Julen Cadiñanos
- Infectious Diseases Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - María Jiménez-González
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
| | - Julián Nevado
- Genomics Laboratory, INGEMM, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Eulalia Valencia
- HIV Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Mario Mayoral-Muñoz
- HIV Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Jose R Arribas
- Infectious Diseases Unit, Department of Internal Medicine, La Paz University Hospital-IdiPAZ, Madrid 28046, Spain
| | - Berta Rodés
- HIV/AIDS and Infectious Diseases Research Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid 28046, Spain
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11
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Robinson-Papp J, Gensler G, Navis A, Sherman S, Ellis RJ, Gelman BB, Kolson DL, Letendre SL, Singer EJ, Valdes-Sueiras M, Morgello S. Characteristics of Motor Dysfunction in Longstanding Human Immunodeficiency Virus. Clin Infect Dis 2021; 71:1532-1538. [PMID: 31587032 DOI: 10.1093/cid/ciz986] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cognitive dysfunction in human immunodeficiency virus (HIV) has decreased, but milder forms of HIV-associated neurocognitive disorders (HAND) persist along with motor dysfunction. The HIV Motor Scale (HMS) is a validated tool that captures motor abnormalities on routine neurologic examination and which is associated with cognitive impairment in HIV. In this study, we applied a modified HMS (MHMS) to a nationwide cohort of people with longstanding HIV to characterize and understand the factors contributing to motor dysfunction. METHODS The National NeuroAIDS Tissue Consortium is a nationwide longitudinal cohort study. Participants undergo regular assessments including neurological examination, neuropsychological testing, and immunovirologic data collection. Data from examinations were used to calculate the MHMS score, which was then correlated with history of AIDS-related central nervous system (CNS) disorders (ARCD; eg, prior CNS opportunistic infection), cerebrovascular disease (CVD), and HAND. RESULTS Sixty-nine percent of participants showed an abnormality on the MHMS, with 27% classified as severe. Results did not vary based on demographic or immunologic variables. The most common abnormalities seen were gait (54%), followed by coordination (39%) and strength (25%), and these commonly co-occurred. CVD (P = .02), history of ARCD (P = .001), and HAND (P = .001) were all associated with higher (ie, worse) HMS in univariate analyses; CVD and ARCD persisted in multivariate analyses. CVD was also marginally associated with symptomatic HAND. CONCLUSIONS Complex motor dysfunction remains common in HIV and is associated with CVD, ARCD, and to a lesser extent, HAND. Future studies are needed to understand the longitudinal trajectory of HIV-associated motor dysfunction, its neural substrates, and impact on quality of life.
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Affiliation(s)
- Jessica Robinson-Papp
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Allison Navis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Ronald J Ellis
- Department of Neurosciences, University of California, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA
| | - Benjamin B Gelman
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Dennis L Kolson
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott L Letendre
- Department of Psychiatry, University of California, San Diego, California, USA.,Department of Medicine, University of California, San Diego, California, USA
| | - Elyse J Singer
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Miguel Valdes-Sueiras
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Susan Morgello
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York.,Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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12
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Epigenetic age acceleration changes 2 years after antiretroviral therapy initiation in adults with HIV: a substudy of the NEAT001/ANRS143 randomised trial. Lancet HIV 2021; 8:e197-e205. [PMID: 33794182 DOI: 10.1016/s2352-3018(21)00006-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/04/2020] [Accepted: 11/20/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND DNA methylation-based estimators of biological age are reliable biomarkers of the ageing process. We aimed to investigate a range of epigenetic ageing biomarkers in a substudy of the NEAT001/ANRS143 clinical trial, which compared ritonavir-boosted darunavir with either raltegravir or tenofovir disoproxil fumarate and emtricitabine in antiretroviral therapy (ART)-naive adults. METHODS We analysed frozen whole blood samples from 168 ART-naive participants with HIV from the NEAT001/ANRS143 trial, before ART initiation and after 2 years of ART (84 participants on ritonavir-boosted darunavir with raltegravir and 84 participants on ritonavir-boosted darunavir with tenofovir disoproxil fumarate and emtricitabine). We also included 44 participants without HIV with a similar age and sex distribution. We analysed DNA methylation. Epigenetic age estimators (Horvath's clock, Hannum's clock, GrimAge, and PhenoAge) and estimated leucocyte compositions were generated using Horvath's New Online Methylation Age Calculator and Houseman's method. We calculated epigenetic age acceleration measures for each estimator of epigenetic age. The NEAT001/ANRS143 trial is registered with ClinicalTrials.gov, NCT01066962. FINDINGS Compared with the HIV-uninfected group, ART-naive participants with HIV showed higher epigenetic age acceleration (EAA) according to all EAA estimators (mean 2·5 years, 95% CI 1·89-3·22 for Horvath-EAA; 1·4 years, 0·74-1·99 for Hannum-EAA; 2·8 years, 1·97-3·68 for GrimAge-EAA; and 7·3 years, 6·40-8·13 for PhenoAge-EAA), with all differences being statistically significant except for Hannum-EAA (Horvath-EAA p=0·0008; Hannum-EAA p=0·059; GrimAge-EAA p=0·0021; and PhenoAge-EAA p<0·0001). Epigenetic ageing was more pronounced in participants who had CD4 counts less than 200 cells per μL (significant for PhenoAge and Hannum's clock, p=0·0015 and p=0·034, respectively) or viral loads over 100 000 copies per mL at baseline (significant for PhenoAge, p=0·017). After 2 years of ART, epigenetic age acceleration was reduced, although PhenoAge and GrimAge remained significantly higher in participants with HIV compared with participants without HIV (mean difference 3·69 years, 95% CI 1·77-5·61; p=0·0002 and 2·2 years, 0·47-3·99; p=0·013, respectively). There were no significant differences in the ART effect on epigenetic ageing between treatment regimens. At baseline, participants with HIV showed dysregulation of DNA methylation-based estimated leucocyte subsets towards more differentiated T-cell phenotypes and proinflammatory leucocytes, which was also partly restored with ART. INTERPRETATION ART initiation partly reversed epigenetic ageing associated with untreated HIV infection. Further studies are needed to understand the long-term dynamics and clinical relevance of epigenetic ageing biomarkers in people with HIV. FUNDING NEAT-ID Foundation.
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13
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Del Amo J, Polo R, Moreno S, Díaz A, Martínez E, Arribas JR, Jarrín I, Hernán MA. Incidence and Severity of COVID-19 in HIV-Positive Persons Receiving Antiretroviral Therapy : A Cohort Study. Ann Intern Med 2020; 173:536-541. [PMID: 32589451 PMCID: PMC7394316 DOI: 10.7326/m20-3689] [Citation(s) in RCA: 234] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The incidence and severity of coronavirus disease 2019 (COVID-19) among HIV-positive persons receiving antiretroviral therapy (ART) have not been characterized in large populations. OBJECTIVE To describe the incidence and severity of COVID-19 by nucleos(t)ide reverse transcriptase inhibitor (NRTI) use among HIV-positive persons receiving ART. DESIGN Cohort study. SETTING HIV clinics in 60 Spanish hospitals between 1 February and 15 April 2020. PARTICIPANTS 77 590 HIV-positive persons receiving ART. MEASUREMENTS Estimated risks (cumulative incidences) per 10 000 persons and 95% CIs for polymerase chain reaction-confirmed COVID-19 diagnosis, hospitalization, intensive care unit (ICU) admission, and death. Risk and 95% CIs for COVID-19 diagnosis and hospital admission by use of the NRTIs tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC), tenofovir alafenamide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and others were estimated through Poisson regression models. RESULTS Of 77 590 HIV-positive persons receiving ART, 236 were diagnosed with COVID-19, 151 were hospitalized, 15 were admitted to the ICU, and 20 died. The risks for COVID-19 diagnosis and hospitalization were greater in men and persons older than 70 years. The risk for COVID-19 hospitalization was 20.3 (95% CI, 15.2 to 26.7) among patients receiving TAF/FTC, 10.5 (CI, 5.6 to 17.9) among those receiving TDF/FTC, 23.4 (CI, 17.2 to 31.1) among those receiving ABC/3TC, and 20.0 (CI, 14.2 to 27.3) for those receiving other regimens. The corresponding risks for COVID-19 diagnosis were 39.1 (CI, 31.8 to 47.6), 16.9 (CI, 10.5 to 25.9), 28.3 (CI, 21.5 to 36.7), and 29.7 (CI, 22.6 to 38.4), respectively. No patient receiving TDF/FTC was admitted to the ICU or died. LIMITATION Residual confounding by comorbid conditions cannot be completely excluded. CONCLUSION HIV-positive patients receiving TDF/FTC have a lower risk for COVID-19 and related hospitalization than those receiving other therapies. These findings warrant further investigation in HIV preexposure prophylaxis studies and randomized trials in persons without HIV. PRIMARY FUNDING SOURCE Instituto de Salud Carlos III and National Institutes of Health.
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Affiliation(s)
| | - Rosa Polo
- Ministry of Health, Madrid, Spain (J.D., R.P.)
| | - Santiago Moreno
- University Hospital Ramón y Cajal and HIV Network of Excellence, Madrid, Spain (S.M.)
| | - Asunción Díaz
- Ministry of Health, HIV Network of Excellence, and Institute of Health Carlos III, Madrid, Spain (A.D.)
| | - Esteban Martínez
- HIV Network of Excellence, Madrid, and University Hospital Clinic, Barcelona, Spain (E.M.)
| | - José Ramón Arribas
- HIV Network of Excellence and University Hospital La Paz, IdiPAZ, Madrid, Spain (J.R.A.)
| | - Inma Jarrín
- HIV Network of Excellence and Institute of Health Carlos III, Madrid, Spain (I.J.)
| | - Miguel A Hernán
- Harvard T.H. Chan School of Public Health and Harvard-MIT Division of Health Sciences and Technology, Boston, Massachusetts (M.A.H.)
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14
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Tost J. 10 years of Epigenomics: a journey with the epigenetic community through exciting times. Epigenomics 2020; 12:81-85. [DOI: 10.2217/epi-2019-0375] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Jörg Tost
- Laboratory for Epigenetics & Environment, Centre National de Recherche en Génomique Humaine, CEA-Institut de Biologie François Jacob, Evry, France
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15
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Blanco JR, Romero L, Ramalle-Gómara E, Metola L, Ibarra V, Sanz M, Oteo JA, Garcia A, Pérez-Martínez L. Retinol-binding protein 4 (RBP4), a potential biomarker of frailty in HIV-infected people on stable antiretroviral therapy. HIV Med 2019; 21:358-364. [PMID: 31885153 DOI: 10.1111/hiv.12837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES A quantitative biomarker for identification of pre-frail and frail persons is still lacking. This study aimed to identify biomarker predictors of frailty in HIV-infected patients. METHODS A cross-sectional study of HIV-infected patients who had been on antiretroviral therapy (ART) for at least 1 year and who presented an undetectable viral load (< 50 HIV-1 RNA copies/mL) at baseline was carried out. For each frail patient, up to four pre-frail and robust patients were randomly selected. The frailty status assessment was based on the five-item criteria described by Fried et al. Sociodemographic, anthropometric, biochemical and HIV-related characteristics were evaluated. Multiple potential biomarkers of frailty and a biological age biomarker were analysed. RESULTS A total of 73 HIV-infected patients on ART for at least 1 year were evaluated. The patients were categorized as robust (n = 33), pre-frail (n = 32) and frail (n = 8) using the Fried criteria. All patients were on ART, with 100% undetectable viral load (< 50 copies/mL) at baseline. No significant differences in demographic, clinical or analytical characteristics were observed among patients in the different categories based on Fried criteria, with the exception of the veterans aging cohort study index (VACS). Similarly, no differences were observed in HIV-related characteristics, although nucleoside reverse transcriptase inhibitor (NRTI) use was less common in frail persons. The distribution of biomarker values varied according to frailty status, with frail persons having higher levels of interleukin (IL)-8, IL-18, CXC chemokine ligand 10 (CXCL10) and retinol-binding protein 4 (RBP4). In multivariable analysis, the assocation of frailty with RBP4 showed a tendency to statistical significance (odds ratio 1.0; 95% confidence interval 0.99-1.00; P < 0.05). CONCLUSIONS Differential biomarker expression was present according to Fried status. Longitudinal studies will clarify the utility of these biomarkers as targets for diagnostic or therapeutic intervention.
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Affiliation(s)
- J-R Blanco
- Biomedical Research Center of La Rioja (CIBIR), Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain.,Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
| | - L Romero
- Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
| | - E Ramalle-Gómara
- Department of Health of the Community of La Rioja, Government of La Rioja, Logroño, Spain
| | - L Metola
- Biomedical Research Center of La Rioja (CIBIR), Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain
| | - V Ibarra
- Biomedical Research Center of La Rioja (CIBIR), Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain
| | - M Sanz
- Biomedical Research Center of La Rioja (CIBIR), Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain
| | - J-A Oteo
- Biomedical Research Center of La Rioja (CIBIR), Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain.,Biomedical Research Center of La Rioja (CIBIR), Logroño, Spain
| | - A Garcia
- Department of Infectious Diseases, San Pedro University Hospital, Logroño, Spain.,Department of Biomedical Diagnosis, San Pedro University Hospital, Logroño, Spain
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16
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Wu C. Commentary: Impact of new hypertension guideline among people living with HIV in Ghana. J Clin Hypertens (Greenwich) 2019; 21:851-852. [PMID: 31125178 DOI: 10.1111/jch.13559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Duke Global Health Institute, Duke University, Durham, North Carolina
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