Institute for Applied Health Research, University of Birmingham, Birmingham, UK.
Department of Infection and Immunology, University Hospitals Birmingham, Birmingham, UK.
HIV Med. 2023 May;24(5):640-647. doi: 10.1111/hiv.13375. Epub 2022 Aug 7.
The impact of HIV infection on the aging process is disputed and largely unknown. We aimed to identify whether people living with HIV experience premature, accelerated, and/or accentuated aging by investigating the development of four age-related non-communicable diseases in people living with versus without HIV.
This population-based matched cohort study design used UK-based primary care electronic health records from the IQVIA Medical Research Database. Between January 2000 and January 2020, all people living with and without HIV aged ≥18 years were eligible. Outcomes included cardiovascular disease (CVD), hypertension, type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD), which were identified by Read codes. We used age at diagnosis to investigate premature aging and age at exit date to investigate accentuation and acceleration. For each outcome, people with and without HIV were excluded if they had the outcome of interest at baseline. Participants were matched based on propensity scores (1:1 ratio). Linear regression was used to report any difference in age at diagnosis between the two groups and to report the prevalence trends for age at exit date.
In total, 8880 people living with HIV were matched with 8880 people without HIV and were found to have an earlier onset of CVD (54.5 vs. 56.8; p = 0.002). Similarly, people living with HIV had an earlier onset of hypertension (49.7 vs. 51.4; p = 0.002). No difference was found for T2DM or CKD (53.4 vs. 52.6; p = 0.368 and 57.6 vs. 58.1; p = 0.483, respectively). The burden of CKD increased over time, whereas no difference in the burden was found for the other conditions.
The earlier development of CVD and hypertension in people living with HIV than in those without HIV indicates premature aging, whereas the increased burden of CKD indicates accelerated aging.
HIV 感染对衰老过程的影响存在争议，且在很大程度上尚未可知。我们旨在通过研究与 HIV 相关的四种非传染性疾病在 HIV 感染者和非感染者中的发展情况，确定 HIV 感染者是否经历过早、加速和/或加剧的衰老。
这是一项基于人群的匹配队列研究设计，使用了来自 IQVIA 医疗研究数据库的英国基础医疗电子健康记录。在 2000 年 1 月至 2020 年 1 月期间，所有年龄在 18 岁及以上的 HIV 感染者和非感染者都符合条件。研究结果包括心血管疾病（CVD）、高血压、2 型糖尿病（T2DM）和慢性肾脏病（CKD），这些结果通过 Read 编码来确定。我们使用诊断时的年龄来研究过早衰老，使用退出日期时的年龄来研究加速衰老。对于每个结果，在基线时患有该结果的 HIV 感染者和非感染者都被排除在外。参与者根据倾向评分（1:1 比例）进行匹配。线性回归用于报告两组之间诊断时年龄的任何差异，并报告退出日期时年龄的流行趋势。
总共匹配了 8880 名 HIV 感染者和 8880 名非感染者，结果发现 HIV 感染者的 CVD 发病年龄较早（54.5 岁比 56.8 岁；p = 0.002）。同样，HIV 感染者的高血压发病年龄也较早（49.7 岁比 51.4 岁；p = 0.002）。对于 T2DM 或 CKD，没有发现差异（53.4 岁比 52.6 岁；p = 0.368 和 57.6 岁比 58.1 岁；p = 0.483）。CKD 的负担随着时间的推移而增加，而其他条件的负担没有差异。
HIV 感染者 CVD 和高血压的发病年龄早于非感染者，表明存在过早衰老，而 CKD 的负担增加表明存在加速衰老。
