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Aging/Comorbidities Update: New Studies-Publications / Conference Aging Studies: EACS / IDSA / ICAAC / IAS / CROI
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[not including HCV which IS a comorbidity associated with HIV]
The First HIV/AIDS Generation Reaches Retirement Age - (09/22/14)
Alarmingly High Comorbidity Rates Among HIV+ - (09/24/15).....cardiovascular events 15.9% up from 9.6% in 2003; chronic kidney disease 16% up from 5% in 2003; renal impairment 20% up from 9.2% in 2003; hypertension 65% up from 34% in 2003; diabetes 31% up from 20% in 2003; hyperlipidemia 47.4% up from 12.1% in 2003; fractures or osteoporosis 11.2% up from 6.7% in 2003...HCV is 13% in medicaid in 2013
High Prevalence of Low Bone Mineral Density and Substantial Bone Loss over 4 Years Among HIV-Infected Persons in the Era of Modern Antiretroviral Therapy - (09/28/15) .......Low BMD was highly prevalent among HIV-infected persons. One-third of participants experienced substantial bone loss despite cART, suggesting the need for monitoring and potential clinical
interventions......Among 170 participants virologically suppressed on cART and with longitudinal BMD data, 31% experienced substantial bone loss (³5% BMD decline from baseline) over 4 years........Of 653 participants included in this analysis (77% male, 29% black, median age 41 years, median CD4+ cell count 464 cells/mm3, 89% with HIV RNA <400 copies/ml), 51% and 10% had baseline osteopenia and osteoporosis, respectively. Low BMD at the femoral neck was significantly more prevalent than for the NHANES controls (47% versus 29%, p<0.001).
Hypertension in HIV - (09/17/15)
Kidney Dysfunction and Markers of Inflammation in the Multicenter AIDS Cohort Study - (09/17/15)
Kidney Disease in HIV - Changing Face Reflcting Growing Burden of Comorbid Disease in Aging HIV+ Population - (09/09/15)
Trends in hospital deaths among human immunodeficiency virus-infected patients during the antiretroviral therapy era, 1995 to 2011..... Comorbidities Death Rates Doubled AIDS-Related death Rates: 70% of Deaths were due to Non-AIDS Related Cause, COMORBIDITIES, while only 29.5% were AIDS-related - (09/24/15)
......"changing trends in chronic HIV disease management.....Clinicians can no longer remain focused on AIDS-defining opportunistic infections and need to recognize the emerging importance of chronic comorbidities when developing a differential diagnosis, and the higher risk of death due to non-AIDS infectious causes....."a substantial proportion of in-hospital deaths were caused by potentially preventable non-AIDS as well as AIDS-related diseases."
HIV+ Fat Tissue is a HIV Reservoir & Inflammation Occurs Within the Fat Tissue due to HIV - 2 studies report - (09/28/15) ......We thus identified adipose tissue as a crucial cofactor in both viral persistence and chronic immune activation/inflammation during HIV infection"
Incidence and progression of coronary artery calcium in HIV-infected and HIV-uninfected men - (11/13/15)
Kidney disease & Hispanic/Latinos in US..... only 18% of individuals with CKD and 34% of those with eGFRcreat-cyst <60 ml/min per 1.73 m2 were aware of having CKD - (11/12/15)
EACS: Real-World Assessment of Renal and Bone Safety Among Patients Exposed to Tenofovir Disoproxil Fumarate-Containing Single Tablet Regimens - (11/05/15)
EACS: Where is the greatest impact of uncontrolled HIV infection on clinical disease progression? - (11/05/15)
The effect of physical activity on cardiometabolic health and inflammation in treated HIV infection - (10/19/15)
Cancer Burden in the HIV-Infected Population in the United States: Anal & Cervical Cancers Increased -Natl Cancer Institute/NIH Report - (10/19/15) .......the burden of non-AIDS-defining cancers has grown among HIV-infected people in the United States.....largely been driven by the growth and aging of the HIV population, and for some cancers, by increasing incidence rates
Parkinson Disease in HIV.....Does HIV Infection Alter Parkinson Disease? - (09/24/15)
(IWCADRH) 17th Intl Workshop on Comorbidities and Adverse Drug Reactions in HIV
Oct 20-22 2015, Barcelona, Spain
Aging/Comorbities at IAS - (08/18/15)
Aging & Comorbidities at ICAAC 2015 & IAS 2015 - (10/02/15)
CROI 2015 - Metabolics / Aging, Senescence / Comorbidities / Inflammation - 3 Exercise Studies / Heart Disease / Statins / Cancers / The Kidney / Bone / TAF / The Brain - neurologic function - (04/01/15)
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EACS - aging-related presentations
regarding aging in the US here is an excerpt I sent recently wrote to some federal US officials:
from Jules: Many aging/older patients are suffering increased rates compared to HIV-negatives of frailty, fracture, brain/cognitive impairment, heart disease, gait problems etc. We WILL see more depression, suicidal ideation, housing & income problems AND mobility & ambulatory problems. Death rates will disproportionately increase. BUT perhaps the most crucial concern which I have been working on is there is no discussion about the services older patients need. There is no policy & no discussion to begin to address policy needs. I have been having discussions with HHS leadership, with NYS officials, and with NIAID leadership about this, and there is no movement to address this. For example, we need support services for these patient's needs on a local level supporting by federal mandate, it could be through Ryan White. We need to address increased depression, there will be increased substance abuse, we need clinics & clinicians that can provide the specialized care for these patients needs - geriatric & comorbidities specialists for HIV. HIV clinics should be taking this on, but they are not. We need exercise & diet programs, because at this point in time exercise & diet are the only known antidotes to address aging. We need education for HIV doctors about each of these comorbidities. We need education for patients. Now that is what NATAP does through our treatment education program, every 3000 patients & providers attend our HCV & HIV symposiums. But of course education is needed in the clinic. And of course through the NATAP listaerves, emails and posting on the website I provide A LOT of education about these aging & HIV issues and of course real time conference reporting & publications on the many related issues for aging & HIV. That is how 8 years ago I got the OAR , the NIH and researchers to appreciate this problem, and I got the OAR & the NIH to provide all the aging funding they do now. But now we need to address the services older patients need. We need local city & state Ryan White Councils & DOH officials to begin discussing local solutions, for example to address housing & income problems, depression, ambulatory & mobility issues. I think this problem will one day explode. I think federal officials are just putting off the inevitable, thats how it works, often human nature is to delay something until it is actually upon you. Until there is more pressure the federal, city and state officials will not respond to this. SO I know and understand we the impact of HIV on an aging population, but I have been unable to make these policy changes happen despite trying.
EACS: Where is the greatest impact of uncontrolled HIV infection on clinical disease progression? - (11/05/15)
EACS: Frailty Predicts All-cause Mortality, Hospital Admission and Falls in HIV-infected and -uninfected Middle-aged Individuals (10/23/15)
EACS: HIV Independently Boosts Odds of Hypertension in Older HIV+/HIV- Cohort - Lipodystrophy/heart disease -(10/23/15)
EACS: PERSISTENT HIV LOW-LEVEL VIREMIA AND CARDIOVASCULAR RISK - (10/30/15)
EACS: Pre-cART pro-Inflammatory Milieu, Microbial Translocation (MT) and risk of disease progression in HIV-Infected Patients, Starting Their First cART: data form the Icona Cohort Foundation (10/26/15)
EACS: EuroSIDA Analysis Suggests Much Lower PSA Cutoff for HIV-Positive Men - (10/27/15)
EACS: Trends in incidences and risk factors for hepatocellular carcinoma & other liver events in HIV/HCV co-infected individuals from 2001 to 2014: a multi-cohort study - (10/30/15)
EACS: No decline in hepatitis C incidence among HIV-positive MSM; an update from the CASCADE Collaboration - (10/30/15)
EACS: Is Response to Anti-HCV Treatment Predictive of Mortality in HCV/HIV Co-infected Patients?..... "SVR -reduced incidence of liver-related death and improved overall survival" (10/27/15)
15th European AIDS Conference (EACS)
October 21-24, 2015
Barcelona
Neuropsychological Impairment in Acute HIV and the Effect of Immediate Antiretroviral Therapy - (11/04/15)
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