Cumulative Human Immunodeficiency Virus (HIV)-1 Viremia Is Associated With Increased Risk of Multimorbidity Among US Women With HIV, 1997–2019. (28th December 2022)

• Record Type: Journal Article
• Authors: Morton, Zoey P; Christina Mehta, C; Wang, Tingyu; Palella, Frank J; Naggie, Susanna; Golub, Elizabeth T; Anastos, Kathryn; French, Audrey L; Kassaye, Seble; Taylor, Tonya N; Fischl, Margaret A; Adimora, Adaora A; Kempf, Mirjam-Colette; Tien, Phyllis C; Ofotokun, Ighovwerha; Sheth, Anandi N; Collins, Lauren F
• Is Part Of: Open forum infectious diseases. Volume 10:Number 2(2023)
• Publication Date: 2022-12-28
• Subjects: cumulative HIV-1 viremia -- multimorbidity -- non-AIDS comorbidities -- viremia copy-years -- women with HIV; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac702
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: To evaluate the effect of cumulative human immunodeficiency virus (HIV)-1 viremia on aging-related multimorbidity among women with HIV (WWH), we analyzed data collected prospectively among women who achieved viral suppression after antiretroviral therapy (ART) initiation (1997–2019). Methods: We included WWH with ≥2 plasma HIV-1 viral loads (VL) <200 copies/mL within a 2-year period (baseline) following self-reported ART use. Primary outcome was multimorbidity (≥2 nonacquired immune deficiency syndrome comorbidities [NACM] of 5 total assessed). The trapezoidal rule calculated viremia copy-years (VCY) as area-under-the-VL-curve. Cox proportional hazard models estimated the association of time-updated cumulative VCY with incident multimorbidity and with incidence of each NACM, adjusting for important covariates (eg, age, CD4 count, etc). Results: Eight hundred six WWH contributed 6368 women-years, with median 12 (Q1–Q3, 7–23) VL per participant. At baseline, median age was 39 years, 56% were Black, and median CD4 was 534 cells/mm 3 . Median time-updated cumulative VCY was 5.4 (Q1–Q3, 4.7–6.9) log10 copy-years/mL. Of 211 (26%) WWH who developed multimorbidity, 162 (77%) had incident hypertension, 133 (63%) had dyslipidemia, 60 (28%) had diabetes, 52 (25%) had cardiovascular disease, and 32 (15%) had kidney disease. Compared with WWH who had time-updated cumulative VCY <5 log10, the adjusted hazard ratio of multimorbidity was 1.99 (95% confidence interval [CI], 1.29–3.08) and 3.78 (95% CI, 2.17–6.58) for those with VCY 5–6.9 and ≥7 log10 copy-years/mL, respectively ( P < .0001). Higher time-updated cumulative VCY increased the risk of each NACM. Conclusions: Among ART-treated WWH, greater cumulative viremia increased the risk of multimorbidity and of developing each NACM, and hence this may be a prognostically useful biomarker for NACM risk assessment in this population. Abstract : Among women with HIV prospectively followed after ART initiation, greater cumulative viremia increased the risk of multimorbidity and incidence of each non-AIDS comorbidity assessed; and hence it may be a prognostically useful biomarker for comorbidity risk assessment in this population.