Gunter Jessie, Callens Steven, De Wit Stephane, Goffard Jean-Christophe, Moutschen Michel, Darcis Gilles, Meuris Christelle, van den Bulcke Charlotte, Fombellida Karine, Del Forge Marc, Razavi Homie, Wyndham-Thomas Chloe
a Center for Disease Analysis , Lafayette , CO , USA.
b University of Ghent Hospital, Internal Medicine , Ghent , Belgium.
Acta Clin Belg. 2018 Feb;73(1):50-53. doi: 10.1080/17843286.2017.1339965. Epub 2017 Jun 16.
In Belgium, eleven AIDS Reference Centers (ARCs) and seven AIDS Reference Laboratories diagnose and treat HIV-positive individuals and track patients under care. As AIDS-related deaths are avoided and the HIV-positive population ages, non-infectious comorbidities (NICMs), such as cardiovascular disease, renal disease and certain cancers, play a larger role in the quality and length of patients' lives. This study aims to characterize the HIV-positive population in Belgium in terms of the prevalence of key NICMs.
We performed a retrospective study of 5787 HIV-positive patients under follow-up at four ARCs across Belgium between 1st of June 2014 and 1st of July 2016.
The mean age of patients under follow-up was 46.7 (SD = 11.6) years, and the mean nadir CD4 count was 268.8 cells/mm (SD = 189.5). The prevalence of diabetes mellitus, arterial hypertension and chronic kidney disease (CKD) were 5.9, 31 and 7.8%, respectively. Cardiovascular events, defined as the occurrence of myocardial infarction, stroke or an invasive coronary procedure, occurred in 2.9% of patients. The highest age-adjusted mortality rates were observed among patients 51-55 years of age. Mortality rates were also higher among patients with CKD and patients with viremic hepatitis C virus (p < 0.05).
Helping the aging HIV-positive population avoids premature morbidity and mortality from NICMs represents a key challenge to further improve patient outcomes. Belgium has an advanced system of HIV care and patient management; however, standardized data collection across ARCs is needed to improve knowledge sharing and to support future countrywide analyses.
在比利时，11个艾滋病参考中心（ARC）和7个艾滋病参考实验室负责诊断和治疗HIV阳性个体，并跟踪接受治疗的患者。随着与艾滋病相关的死亡得以避免，且HIV阳性人群老龄化，心血管疾病、肾病和某些癌症等非感染性合并症（NICM）在患者生活质量和寿命方面发挥着更大作用。本研究旨在根据关键NICM的患病率来描述比利时HIV阳性人群的特征。
我们对2014年6月1日至2016年7月1日期间在比利时4个ARC接受随访的5787例HIV阳性患者进行了一项回顾性研究。
接受随访患者的平均年龄为46.7（标准差=11.6）岁，平均最低CD4细胞计数为268.8个/立方毫米（标准差=189.5）。糖尿病、动脉高血压和慢性肾脏病（CKD）的患病率分别为5.9%、31%和7.8%。心血管事件定义为心肌梗死、中风或侵入性冠状动脉手术的发生，在2.9%的患者中出现。在51 - 55岁的患者中观察到最高的年龄调整死亡率。CKD患者和丙型肝炎病毒血症患者的死亡率也较高（p<0.05）。
帮助老龄化的HIV阳性人群避免因NICM导致的过早发病和死亡是进一步改善患者结局的一项关键挑战。比利时拥有先进的HIV护理和患者管理系统；然而，需要在各ARC之间进行标准化数据收集，以改善知识共享并支持未来的全国性分析。
