Among people living with HIV, traditional risk factors outweigh HIV-related risks as a cause of many health complications, an analysis published in The Lancet found.
Researchers calculated population attributable fractions (PAFs) among participants living with HIV who developed non-AIDS-defining cancers, end-stage liver or kidney diseases, or myocardial infarctions (MIs). PAFs quantify the proportional reduction in an illness, if the associated risk factor was eliminated (e.g., nobody smoked).
They found that addressing non-HIV risks could curb a significant proportion of these conditions: Smoking prevention, for instance, could avoid 24% of non-AIDS-defining cancers and 37% of MIs, while hypercholesterolemia prevention could avoid 44% of MIs. By contrast, the effect of CD4 count and viral load management was more muted: Keeping a person's CD4 count at or above 200 could avoid 3% of non-AIDS-defining-cancers and 6% of MIs, while maintaining a viral load below 400 copies/mL could avoid 2% of non-AIDS-defining cancers and 5% of MIs, the authors calculated.
Study authors recommended screening people living with HIV for such traditional risks. However, researchers Line D. Rasmussen and Niels Obel wondered in a related commentary whether increased screenings might rekindle stigma.
Both the study authors and commentators did appear to agree that limited resources needed to be allocated in a way that most effectively maintains the health of an aging population living with HIV.