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High Rates of Age-Related Disease With HIV -- But No Sign of Accelerated Aging

August 13, 2015

HIV-positive people ran a higher absolute risk of nearly all age-related diseases studied than did people in the general population, according to results of a population-matching analysis in Denmark. But relative risk of most age-related diseases fell with age in people with HIV compared with controls. And age-standardized and relative risks of cardiovascular disease, cancers and severe neurocognitive disease did not rise substantially after HIV diagnosis or after antiretroviral therapy began. These findings do not support the concept of accelerated aging in people with HIV.

HIV populations have higher rates of several age-related diseases than do comparison groups. Such findings led to the idea that HIV-positive people experience "accelerated aging" compared with HIV-negative people. But it remains uncertain whether people with HIV age faster in the sense that their risk of age-related disease accelerates with time after HIV diagnosis or starting antiretroviral therapy.

To address these issues, researchers explored age-related disease rates in 5897 HIV-positive adults in Denmark and 53,073 general-population controls matched for age, sex and study entry date. All HIV-positive people were in care at some point between January 1995 and June 2014, and no study participants had an age-related disease before the date of study entry. The age-related diseases considered were myocardial infarction, stroke, virus-associated cancers, smoking-related cancers, other cancers, severe neurocognitive disease, chronic kidney disease, chronic liver disease and osteoporotic fracture. The study group had a median age of 36.8 years, and three-quarters of study participants were men.

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The researchers found that absolute risk of age-related diseases was always higher in HIV-positive individuals when compared to HIV-negative counterparts, with one exception: For the category of "other cancers," absolute risk rose with age in parallel in people with and without HIV. However, relative risk of all age-related diseases except fracture dropped with age in HIV-positive people compared with HIV-negative controls. Age-standardized risk of cardiovascular disease, cancers and severe neurocognitive disease did not climb substantially with time since HIV diagnosis or the start of antiretroviral therapy. Age-standardized and relative risks of chronic liver disease and osteoporotic fracture did appear to increase with time since HIV diagnosis and treatment initiation

The researchers believe "HIV-infected individuals can be assured that their overall risk of major age-related diseases does not seem to increase independently of age." They propose that "the duration of HIV-induced chronic immune activation and sustained inflammation after initiation of [antiretroviral therapy] do not substantially increase the risk of cardiovascular diseases, cancers, or severe neurocognitive disease."

Mark Mascolini is a freelance writer focused on HIV infection.


Copyright © 2015 Remedy Health Media, LLC. All rights reserved.




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