Cumulative Human Immunodeficiency Virus (HIV)-1 Viremia Is Associated With Increased Risk of Multimorbidity Among US Women With HIV, 1997-2019.
| dc.contributor.author | Morton, Zoey P | |
| dc.contributor.author | Christina Mehta, C | |
| dc.contributor.author | Wang, Tingyu | |
| dc.contributor.author | Palella, Frank J | |
| dc.contributor.author | Naggie, Susanna | |
| dc.contributor.author | Golub, Elizabeth T | |
| dc.contributor.author | Anastos, Kathryn | |
| dc.contributor.author | French, Audrey L | |
| dc.contributor.author | Kassaye, Seble | |
| dc.contributor.author | Taylor, Tonya N | |
| dc.contributor.author | Fischl, Margaret A | |
| dc.contributor.author | Adimora, Adaora A | |
| dc.contributor.author | Kempf, Mirjam-Colette | |
| dc.contributor.author | Tien, Phyllis C | |
| dc.contributor.author | Ofotokun, Ighovwerha | |
| dc.contributor.author | Sheth, Anandi N | |
| dc.contributor.author | Collins, Lauren F | |
| dc.date.accessioned | 2023-03-02T15:06:40Z | |
| dc.date.available | 2023-03-02T15:06:40Z | |
| dc.date.issued | 2023-02 | |
| dc.date.updated | 2023-03-02T15:06:39Z | |
| dc.description.abstract | BackgroundTo 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).MethodsWe 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).ResultsEight 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/mm3. 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.ConclusionsAmong 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. | |
| dc.identifier | ofac702 | |
| dc.identifier.issn | 2328-8957 | |
| dc.identifier.issn | 2328-8957 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Oxford University Press (OUP) | |
| dc.relation.ispartof | Open forum infectious diseases | |
| dc.relation.isversionof | 10.1093/ofid/ofac702 | |
| dc.subject | cumulative HIV-1 viremia | |
| dc.subject | multimorbidity | |
| dc.subject | non-AIDS comorbidities | |
| dc.subject | viremia copy-years | |
| dc.subject | women with HIV | |
| dc.title | Cumulative Human Immunodeficiency Virus (HIV)-1 Viremia Is Associated With Increased Risk of Multimorbidity Among US Women With HIV, 1997-2019. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Naggie, Susanna|0000-0001-7721-6975 | |
| pubs.begin-page | ofac702 | |
| pubs.issue | 2 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Medicine, Infectious Diseases | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.publication-status | Published | |
| pubs.volume | 10 |
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