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Danish Study Raises Questions About Accelerated Aging in HIV

July 20, 2015

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In the past decade reports have suggested that some HIV-positive people are at heightened risk for aging-related issues including the following:

  • heart attack
  • stroke
  • some cancers
  • severe organ injury and dysfunction
  • fractures

This has led some researchers to theorize that perhaps HIV infection is associated with accelerated aging.

A team of researchers in Denmark has been pondering the potential effect of HIV on the aging process. They think that if HIV does accelerate the aging process then the risks of developing severe age-related diseases should increase over time as people with HIV live longer.

To explore the issue of HIV and aging, the Danish team analysed health-related data collected over a period of 20 years from both HIV-negative and HIV-positive people. They found that while age-related diseases were relatively common among HIV-positive people, overall severe age-related complications were not common. Thus the team concluded that accelerated aging was not linked to HIV. Later in this CATIE News bulletin we explore this conclusion as well as possible limitations of the Danish study.


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Study Details

In Denmark, several large databases exist to capture health-related information from citizens and residents. The information in these databases can be analysed by researchers who are studying different health conditions. Danish researchers are known for their close monitoring of the HIV epidemic in that country.

In the present study, data were gathered from HIV-positive people from January 1995 to June 2014. People who were diagnosed with age-related conditions before the start of the study were excluded from analysis.

The researchers focused on trends. Specifically they sought to assess the length of time it took for one of the age-related conditions they were monitoring to occur. They relied on hospitals and clinics to make a diagnosis and record this diagnosis. In cases where participants had died, the research team also made use of analysing data from death certificates.

The diseases on which the team focused were as follows:

  • heart attack
  • stroke
  • virus-associated cancers, including lymphoma, Kaposi's sarcoma (KS), liver cancer and cancers of the anus, cervix, penis and vulva
  • smoking-related cancers, including cancers of the lung, head and neck and bladder cancer
  • other cancers
  • chronic brain dysfunction
  • chronic kidney dysfunction
  • chronic liver dysfunction
  • fractures due to osteoporosis

Data from 5,897 HIV-positive people were analysed and their average profile at the time they entered the study was as follows:

  • 76% men, 24% women
  • age -- 37 years
  • common routes of HIV infection (percentages do not add up to 100 due to rounding): men who had sex with men -- 46%; people who injected street drugs -- 10%; heterosexual contact -- 37%; other routes -- 6%
  • co-infection with hepatitis C virus -- 15%
  • CD4+ cell count -- 300 cells/mm3

Data from HIV-positive people were compared to data from 53,073 HIV-negative people. In other words, data from each HIV-positive person were compared to data from nine HIV-negative people.


Results -- Overall

In general, HIV-positive people were more likely to have severe forms of age-related diseases than HIV-negative people. Here is the distribution of the specific conditions monitored by the research team:

Heart attack

  • HIV-positive people -- 3%
  • HIV-negative people -- 2%

Stroke

  • HIV-positive people -- 4%
  • HIV-negative people -- 3%

Chronic kidney dysfunction

  • HIV-positive people -- 2%
  • HIV-negative people -- 0.7%

Chronic liver dysfunction

  • HIV-positive people -- 2%
  • HIV-negative people -- 0.7%

Chronic brain dysfunction

  • HIV-positive people -- 2%
  • HIV-negative people -- 0.4%

Osteoporosis-related fractures

  • HIV-positive people -- 8%
  • HIV-negative people -- 6%

Virus-associated cancers

  • HIV-positive people -- 5%
  • HIV-negative people -- 0.5%

Smoking-associated cancers

  • HIV-positive people -- 2%
  • HIV-negative people -- 1%

Other cancers

  • HIV-positive people -- 3%
  • HIV-negative people -- less than 4%

Statistical analysis found that among HIV-positive people the relative risk of developing certain events or conditions was generally greater than among HIV-negative people, as follows:

  • heart attack -- two-fold elevated risk
  • stroke -- two-fold elevated risk
  • virus-associated cancer -- 14-fold elevated risk
  • smoking-associated cancer -- two-fold elevated risk
  • other cancers -- 17% increased risk
  • chronic neurocognitive problems -- five-fold elevated risk
  • chronic kidney dysfunction -- four-fold elevated risk
  • chronic liver dysfunction -- four-fold elevated risk
  • osteoporosis-related fractures -- two-fold elevated risk

In reviewing the results, readers can see that in most cases the specific conditions as well as the risks for them were elevated among HIV-positive people. However, overall, relatively small proportions of HIV-positive people had severe forms of these diseases.

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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication CATIE News. Visit CATIE's Web site to find out more about their activities, publications and services.
 

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