Rate of cardiovascular,renal and bone disease and their major risks factors in HIV-infected individuals on antiretroviral therapy in Spain |
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| Affiliation: | 1. Servicio Enfermedades Infecciosas, Hospital del Mar, Barcelona;2. Unidad Enfermedades Infecciosas, Hospital de la Santa Creu I Sant Pau, Barcelona; Servicio Enfermedades Infecciosas;3. Hospital Infanta Elena, Huelva;4. Servicio Enfermedades Infecciosas, University General Hospital, Elche;5. Servicio Enfermedades Infecciosas, Hospital Clinico San Carlos-IdiSSC, Madrid;6. Servicio Enfermedades Infecciosas, Hospital Virgen de la Victoria, Malaga;7. Servicio Enfermedades Infecciosas, Hospital Clínico Universitario, Santiago;8. Servicio Enfermedades Infecciosas, Hospital de San Pedro, Logroño;9. Servicio de Nefrología, Hospital Universitario de Bellvitge, Barcelona;10. Servicio de Cardiología, Hospital Universitario La Paz, Madrid;1. Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Spain;2. Chelsea and Westminster NHS Foundation Trust and Imperial College London, UK;3. Internal Medicine Department, Infectious diseases & HIV Unit, Hospital La Paz, Madrid, Spain;1. Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Madrid, España;2. Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España;1. Plan Andaluz frente al VIH/sida y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain;2. Grupo de Enfermedades Infecciosas de la Unidad de Medicina Interna, Hospital Costa del Sol, Málaga, Spain;3. Centro de Rickettsiosis y Enfermedades Transmitidas por Artrópodos Vectores, Departamento de Enfermedades Infecciosas, Hospital Universitario San Pedro-Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, La Rioja, Spain;4. Servicio de Medicina Interna, Complejo Hospitalario San Millán-San Pedro, Logroño, Spain;5. Comisión Ciudadana Anti-Sida de La Rioja (CCASLR), Logroño, La Rioja, Spain;6. Vigilancia, Prevención y Control de las Infecciones de Transmisión Sexual y el VIH, Subdirección General de Vigilancia y Respuesta a Emergencias de Salud Pública, Agencia de Salud Pública de Cataluña, Departamento de Salud, Generalidad de Cataluña, Barcelona, Spain;7. Plan Andaluz frente al VIH y otras ITS, Consejería de Salud y Consumo de la Junta de Andalucía, Spain;8. Government Affairs Ass, Gilead Sciences, Madrid, Spain;9. Servicio de Farmacia, Hospital de Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain;10. Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain;11. Departamento de Psicología Social y de las Organizaciones, UNED, Madrid, Spain;12. Sociedad Española Interdisciplinaria del Sida (SEISIDA), Madrid, Spain;13. CSUR de Enfermedades Tropicales, Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain;14. Programa de Prevención, Control y Atención al VIH, las ETS y las Hepatitis Víricas de la Agencia de Salud Pública de Catalunya, Generalitat de Catalunya, Barcelona, Spain;1. Departamento de Biología Molecular y Genómica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico;2. Instituto de Investigación en Inmunodeficiencias y VIH, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico;3. Asociación Mexicana para el Fomento a Innovación, El Arenal, Jalisco, Mexico |
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| Abstract: | BackgroundThe life expectancy of HIV-infected individuals has dramatically improved with potent antiretroviral therapies. However, organ-specific toxicities of some antiretrovirals and persistent inflammation and immune activation due to residual virus replication account for a high burden of age-associated comorbidities in the HIV population.MethodsThe prevalence of overt cardiovascular, renal and bone diseases as well as their major risk factors were cross-sectionally examined during the year 2014 in the VACH cohort, a large nationwide population of HIV-infected individuals in Spain.ResultsA total of 10,897 HIV-infected patients were examined. Seventy-one point four percent were male and the mean age was 48 years. Mean time since HIV diagnosis was 15.8 years and mean time on antiretroviral therapy was 13.1 years. The proportion of patients with undetectable viral load was 87.1%, whereas 65.7% had CD4 counts >500 cells/mm3. Overall, cardiovascular, renal and bone disease were recorded in 4.7%, 5.9% and 2.8%, respectively. The prevalence of major risk factors was as follows: smoking 51.3%, alcohol abuse 7.8%, overweight/obesity 42.2%, diabetes 19.9%, dyslipidaemia 72.6%, hypertension 25.6%, and osteoporosis 11.1%. In the subset of patients older than 55 years-old (18%), all figures for overt disease and their major risk factors were significantly greater.ConclusionMajor age-related medical conditions and most of their risk factors are highly prevalent in HIV-infected individuals on long-term antiretroviral therapy in Spain. Preventive actions, including careful selection of antiretroviral agents, should be prioritized in the ageing HIV population. |
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| Keywords: | chronic kidney disease tenofovir HIV cardiovascular disease ageing Enfermedad renal crónica Tenofovir VIH Enfermedad cardiovascular Envejecimiento |
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