Department of Infectious Diseases, Centro Hospitalar de São João, Porto, Portugal.
Department of Infectious Diseases, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
Int J Infect Dis. 2019 Feb;79:94-100. doi: 10.1016/j.ijid.2018.10.011. Epub 2018 Oct 25.
To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1-infected population and to explore the factors associated with multiple NARC.
This was a multicentre, cross-sectional study including HIV-1-infected patients aged ≥50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC.
Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B=0.032, 95% confidence interval 0.015-0.049; p=0.0003) and between the duration of HIV-1 infection and NARC (B=0.039, 95% confidence interval 0.017-0.059; p=0.0005).
A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.
描述老年 HIV-1 感染者中非艾滋病相关共病（NARC）的特征，并探讨与多种 NARC 相关的因素。
这是一项多中心、横断面研究，纳入了年龄≥50 岁、病毒学抑制且已接受稳定抗逆转录病毒治疗（ART）方案至少 6 个月的 HIV-1 感染者。采用多元回归模型探讨了人口统计学和临床变量与 NARC 数量之间的关系。
共纳入 401 例患者，平均年龄为 59.3 岁，72.6%为男性。HIV-1 感染的平均时间为 12.0 年，ART 暴露的中位数为 10.0 年。NARC 的平均数量为 2.1，34.7%的患者有三种或更多种 NARC。高胆固醇血症是最常见的 NARC（60.8%），其次是动脉高血压（39.7%）和慢性抑郁/焦虑（23.9%）。动脉高血压和糖尿病是最常治疗的 NARC（分别为 95.6%和 92.6%的病例）。线性回归分析显示，年龄与 NARC 呈正相关（B=0.032，95%置信区间 0.015-0.049；p=0.0003），HIV-1 感染持续时间与 NARC 呈正相关（B=0.039，95%置信区间 0.017-0.059；p=0.0005）。
发现 NARC 的患病率较高，最常见的是代谢、心血管和心理疾病。NARC 的发生率与一般人群相似，表明除 HIV 感染外，还存在更大的社会问题。多学科方法对于减轻 HIV-1 感染者中复杂多疾病的负担至关重要。
