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Changes in the Prevalence of Cardiovascular, Renal and Bone Co-Morbidities and Related Risk Factor in HIV-Infected Patients in The Spanish VACH Cohort: A Cross-Sectional Study in 2010 and 2014....
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"within 4 years from 2010 to 2014 there is a 44% increase in the prevalence of history of CV event. This is concordant with the higher prevalence of diabetes, hypertension, dyslipidemia, and obesity. Diabetes, hypertension and dyslipidima increased between 10% and 45%. For history of renal impairment and fracture, the increase was 24% and 42%, respectively......the proportion of patients on high risk for progression to chronic kidney disease increased 28% (Figure 4)....In 2014, 45% of patients had medium/high risk of coronary heart disease (Figure 5). Of these, 87% also medium/high risk of progressing to chronic kidney disease. Overall, 39% of patients had simultaneously moderate/high risk of chronic kidney disease and chronic heart disease (CHD) Table 3, and approximately two thirds were on TDF or ABC."
from Jules: if you were break down the prevalence by age group for which they have 1000 patients over 60 & 200 patients over 70 I expect you would see a much worse scenario for these patients, and of course as time passes very soon a much larger percentage of patients in Spain will be over 60 & over 70, when these prevalence numbers & mortality is likely to soar & then consider the healthcare economics of providing care & treatment, - it costs a lot to provide all the polypharmacy not to mention the adherence challenges & consequent viralogic failures - and an Italian study by Giovanni Guaraldi estimated in 14 years in Italy 75% of older patients will be frail & 34% will need to be confined to old age home because they are so disabled.
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Reported by Jules Levin
HIV Glasgow 2016 Oct 23-26
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