Observational Study

. 2019 Jan 25;9(1):e024841.

doi: 10.1136/bmjopen-2018-024841.

HIV-related excess mortality and age-related comorbidities in patients with HIV aged ≥60: a relative survival analysis in the French Dat'AIDS cohort

Maxime Hentzien^{1

2}, Moustapha Dramé^{2

3}, Cyrille Delpierre^{4

5}, Clotilde Allavena⁶, André Cabié⁷, Lise Cuzin^{4

8}, David Rey⁹, Pascal Pugliese¹⁰, Guy Hédelin¹¹, Firouzé Bani-Sadr¹; Dat’AIDS Study Group

Collaborators, Affiliations

Collaborators

Dat’AIDS Study Group:
Yazdanpanah Y, Hoen B, Peytavin G, Jacomet C, Isnard-Bagnis C, Peyramond D, Joly V May, S Brégigeon, O Zaegel-Faucher, V Obry-Roguet, H Laroche, M Orticoni, Mj Soavi, E Ressiot, M Carta- Padovani, Mj Ducassou, I Jaquet, S Galie, A Galinier, P Martinet, M Landon, As Ritleng, A Ivanova, C Blanco- Betancourt, C Debreux, C Lions, I Poizot-Martin, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte L, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, P Pugliese, L Bentz, C Ceppi, E Cua, J Cottalorda, J Durant, S Ferrando, Jg Fuzibet, R Garraffo, V Mondain, A Naqvi, I Perbost, S Pillet, B Prouvost-Keller, C Pradier, SWehrlen-Pugliese, Pm Roger, E Rosenthal, P Dellamonica, F Raffi, C Allavena, E Billaud, C Biron, B Bonnet, S Bouchez, D Boutoille, L Khatchatourian, C Brunet, T Jovelin, N Hall, C Bernaud, P Morineau, V Reliquet, O Aubry, P Point, M Besnier, H Hüe, M Cavellec, A Soria, S Pineau, E André-Garnier, A Rodallec, V Ferré, L Leguen, M Lefebvre, O Grossi, A Cheret, P Choisy, C Duvivier, Ph Consigny, G Cessot, P Bossi, A Gergely, J Goesch, J Gilquin, G Benabdelmoumen, F Lanternier, C Charlier, K Amazzough, B Henry, B Pilmis, C Rouzaud, M Morgand, F Touam, C Louisin, O Lortholary, R Guery, F Danion, J Lourenco, P Parize, N Etienne, M Launay, C Rouzioux, V Avettand Fenoel, Ma Valantin, R Agher, C Katlama, S Abel, R Césaire, G Dos Santos, L Fagour, M Illiaquer, F Najioullah, D Nguyen, M Ouka, S Pierre-François, J Pasquier, M Pircher, B Rozé, A Cabié, D Rey, P Fischer, M Partisani, C Cheneau, M Priester, C Bernard-Henry, Ml Batard, E De Mautort, C Chirouze, Q Gardiennet, F Bani-Sadr, Jl Berger, Y N'Guyen, D Lambert, I Kmiec, M Hentzien, C Migault, D Lebrun, V Brodard, L Cotte, C Chidiac, T Ferry, F Ader, F Biron, A Boibieux, P Miailhes, T Perpoint, I Schlienger, J Lippmann, E Braun, J Koffi, C Longuet, V Guéripel, C Augustin-Normand, C Brochier, S Degroodt

Affiliations

¹ Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, CHU Reims, Reims, France.
² Université de Reims Champagne-Ardenne, France, Reims, France.
³ Department of Research and Innovation, Reims Teaching Hospitals, Robert Debré Hospital, Reims, France.
⁴ INSERM, UMR1027, Toulouse, France.
⁵ Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France.
⁶ Infectious Diseases Department, University of Nantes, CHU Hôtel Dieu, Nantes, France.
⁷ Department of Infectious and Tropical Diseases, Martinique Teaching Hospitals, Fort-De-France Hospital, Fort-De-France, France.
⁸ CHU Toulouse, COREVIH Toulouse, Toulouse, France.
⁹ Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, HIV Care Center, Strasbourg, France.
¹⁰ Infectious Diseases Department, University of Nice, CHU L'Archet, Nice, France.
¹¹ Epidémiologie en entreprises. INRS, Vandoeuvre, France.

PMID: 30782744
PMCID: PMC6352790
DOI: 10.1136/bmjopen-2018-024841

Observational Study

HIV-related excess mortality and age-related comorbidities in patients with HIV aged ≥60: a relative survival analysis in the French Dat'AIDS cohort

Maxime Hentzien et al. BMJ Open. 2019.

. 2019 Jan 25;9(1):e024841.

doi: 10.1136/bmjopen-2018-024841.

Authors

Collaborators

Dat’AIDS Study Group:
Yazdanpanah Y, Hoen B, Peytavin G, Jacomet C, Isnard-Bagnis C, Peyramond D, Joly V May, S Brégigeon, O Zaegel-Faucher, V Obry-Roguet, H Laroche, M Orticoni, Mj Soavi, E Ressiot, M Carta- Padovani, Mj Ducassou, I Jaquet, S Galie, A Galinier, P Martinet, M Landon, As Ritleng, A Ivanova, C Blanco- Betancourt, C Debreux, C Lions, I Poizot-Martin, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte L, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, P Pugliese, L Bentz, C Ceppi, E Cua, J Cottalorda, J Durant, S Ferrando, Jg Fuzibet, R Garraffo, V Mondain, A Naqvi, I Perbost, S Pillet, B Prouvost-Keller, C Pradier, SWehrlen-Pugliese, Pm Roger, E Rosenthal, P Dellamonica, F Raffi, C Allavena, E Billaud, C Biron, B Bonnet, S Bouchez, D Boutoille, L Khatchatourian, C Brunet, T Jovelin, N Hall, C Bernaud, P Morineau, V Reliquet, O Aubry, P Point, M Besnier, H Hüe, M Cavellec, A Soria, S Pineau, E André-Garnier, A Rodallec, V Ferré, L Leguen, M Lefebvre, O Grossi, A Cheret, P Choisy, C Duvivier, Ph Consigny, G Cessot, P Bossi, A Gergely, J Goesch, J Gilquin, G Benabdelmoumen, F Lanternier, C Charlier, K Amazzough, B Henry, B Pilmis, C Rouzaud, M Morgand, F Touam, C Louisin, O Lortholary, R Guery, F Danion, J Lourenco, P Parize, N Etienne, M Launay, C Rouzioux, V Avettand Fenoel, Ma Valantin, R Agher, C Katlama, S Abel, R Césaire, G Dos Santos, L Fagour, M Illiaquer, F Najioullah, D Nguyen, M Ouka, S Pierre-François, J Pasquier, M Pircher, B Rozé, A Cabié, D Rey, P Fischer, M Partisani, C Cheneau, M Priester, C Bernard-Henry, Ml Batard, E De Mautort, C Chirouze, Q Gardiennet, F Bani-Sadr, Jl Berger, Y N'Guyen, D Lambert, I Kmiec, M Hentzien, C Migault, D Lebrun, V Brodard, L Cotte, C Chidiac, T Ferry, F Ader, F Biron, A Boibieux, P Miailhes, T Perpoint, I Schlienger, J Lippmann, E Braun, J Koffi, C Longuet, V Guéripel, C Augustin-Normand, C Brochier, S Degroodt

Affiliations

¹ Department of Internal Medicine, Infectious Diseases, and Clinical Immunology, CHU Reims, Reims, France.
² Université de Reims Champagne-Ardenne, France, Reims, France.
³ Department of Research and Innovation, Reims Teaching Hospitals, Robert Debré Hospital, Reims, France.
⁴ INSERM, UMR1027, Toulouse, France.
⁵ Université Toulouse III Paul-Sabatier, UMR1027, Toulouse, France.
⁶ Infectious Diseases Department, University of Nantes, CHU Hôtel Dieu, Nantes, France.
⁷ Department of Infectious and Tropical Diseases, Martinique Teaching Hospitals, Fort-De-France Hospital, Fort-De-France, France.
⁸ CHU Toulouse, COREVIH Toulouse, Toulouse, France.
⁹ Hôpitaux universitaires de Strasbourg, Nouvel Hôpital Civil, HIV Care Center, Strasbourg, France.
¹⁰ Infectious Diseases Department, University of Nice, CHU L'Archet, Nice, France.
¹¹ Epidémiologie en entreprises. INRS, Vandoeuvre, France.

PMID: 30782744
PMCID: PMC6352790
DOI: 10.1136/bmjopen-2018-024841

Abstract

Objective: The objective was to evaluate the association between age-related comorbidities (ARCs) and 5-year HIV-related excess mortality in people living with HIV aged ≥60 years.

Design: Cohort study using relative survival analysis (Estève's model).

Setting: The French multicentre prospective Dat'AIDS cohort that involves 12 French hospitals.

Participants: Inclusion of 1415 HIV-1 infected patients actively followed aged ≥60 years on January 2008, with a 5-year follow-up period in the late combination antiretroviral therapy era.

Results: Among 1415 patients included, 154 died. By multivariable analysis, factors predictive of 5-year HIV-related excess mortality were non-AIDS-related cancer (adjusted excess HR (aEHR)=2.94; 95% CI 1.32 to 6.57), cardiovascular disease (aEHR=6.00; 95% CI 2.45 to 14.65), chronic renal disease (aEHR=4.86; 95% CI 2.24 to 10.53), cirrhosis (aEHR=3.58; 95% CI 1.25 to 10.28), hepatitis C co-infection (aEHR=3.63; 95% CI 1.44 to 9.12), body mass index<18.5 kg/m² (aEHR=4.10; 95% CI 1.61 to 10.48) and having a CD4 cell count ≤200/mm³ (aEHR=5.79; 95% CI 2.28 to 14.69).

Conclusions: ARCs, particularly cardiovascular disease and chronic renal disease, are predictive of HIV-related excess mortality, with an increase in hazard similar to that of CD4 cell count.

Trial registration number: NCT02898987.

Keywords: HIV infection; aged; cardiovascular diseases; comorbidities; dat’aids cohort; relative survival.

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Conflict of interest statement

Competing interests: None declared.

References

1. Sabin CA. Do people with HIV infection have a normal life expectancy in the era of combination antiretroviral therapy? BMC Med 2013;11:251 10.1186/1741-7015-11-251 - DOI - PMC - PubMed
1. Retour d’Informations Clinico-Epidémiologiques (RICE) - février. 2013. http://www.ccde.fr/_fold/fl-1364308704-649.pdf (Accessed 24 Jun 2016).
1. Guaraldi G, Orlando G, Zona S, et al. . Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis 2011;53:1120–6. 10.1093/cid/cir627 - DOI - PubMed
1. Hentzien M, Dramé M, Allavena C, et al. . Impact of age-related comorbidities on five-year overall mortality among elderly hiv-infected patients in the late haart era-role of chronic renal disease. J Nutr Health Aging 2016;20:408–14. 10.1007/s12603-015-0608-7 - DOI - PubMed
1. Hentzien M, Delpierre C, Pugliese P, et al. . Derivation and internal validation of a mortality risk index for aged people living with HIV: The Dat’AIDS score. PLoS One 2018;13:e0195725 10.1371/journal.pone.0195725 - DOI - PMC - PubMed

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HIV-related excess mortality and age-related comorbidities in patients with HIV aged ≥60: a relative survival analysis in the French Dat'AIDS cohort

Collaborators

Affiliations

HIV-related excess mortality and age-related comorbidities in patients with HIV aged ≥60: a relative survival analysis in the French Dat'AIDS cohort

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources

Medical

Research Materials