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Comorbidities and cardiovascular risk factors in an aged cohort of HIV-infected patients on antiretroviral treatment in a Spanish hospital in 2016
Authors:Carmen Fontela  Jesús Castilla  Regina Juanbeltz  Iván Martínez-Baz  María Rivero  Aisling O’Leary
Affiliation:1. Department of Pharmacy, Complejo Hospitalario de Navarra, Pamplona, Spain;2. Navarrabiomed-Miguel Servet Foundation, Pamplona, Spain;3. Instituto de Salud Pública de Navarra, Pamplona, Spain;4. IdiSNA - Navarra Institute for Health Research, Pamplona, Spain;5. CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;6. Department of Infectious diseases, Complejo Hospitalario de Navarra, Pamplona, Spain;7. National Centre for Pharmacoeconomics, St James’ Hospital, Dublin, Ireland;8. School of Pharmacy, Royal College of Surgeons of Ireland, Dublin, Ireland
Abstract:
Objectives: The increased survival of HIV-infected individuals has resulted in a premature aging of this population, with the consequent development of premature age-related comorbidities and risk factors. We aimed to describe the prevalence of age-related comorbidities and cardiovascular risk factors in older adults with HIV infection on antiretroviral therapy (ART).

Methods: A retrospective cross-sectional study was undertaken in a cohort of HIV patients aged ≥50 years on ART in September 2016 in Spain. The prevalence of comorbidities (liver cirrhosis, respiratory diseases, cancer, cardiovascular, diabetes, and kidney and bone disorders) and risk factors (smoking, dyslipidemia, and arterial hypertension) was captured.

Results: Among the 339 patients included in the study, any comorbidity was present in 52%, the most common being cirrhosis (19%), chronic lung disease (13%), and diabetes mellitus (11%). Over three quarters (78%) had any risk factor: dyslipidemia (55%) and smoking (44%). A higher prevalence of cardiovascular disease was seen in patients ≥60 years in comparison to those aged 50–59 years (23% vs 8%, p = 0.001). Of all study patients, 44% took more than three drugs in addition to their ART, while 29% received no additional pharmacological interventions.

Conclusions: Comorbidities and risk factors for chronic diseases are very common in HIV-infected patients aged ≥50 years and increase with age, so they should be early considered in the clinical management of these patients. It is important to encourage healthy lifestyles to prevent comorbidities and to control risk factors. Concomitant treatments with ART should be carefully monitored to prevent drug interactions, adverse effects, and patient adherence failures.

Keywords:HIV  comorbidity  risk factor  antiretroviral therapy
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