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. 2024 Apr 16:11:1380731.
doi: 10.3389/fmed.2024.1380731. eCollection 2024.

Non-AIDS-defining comorbidities impact health related quality of life among older adults living with HIV

Alice Zhabokritsky  1 , Marina Klein  2 , Mona Loutfy  3 , Giovanni Guaraldi  4 , Nisha Andany  5 , Silvia Guillemi  6 , Julian Falutz  2 , Gordon Arbess  7 , Darrell H S Tan  8 , Sharon Walmsley  1
Affiliations

Non-AIDS-defining comorbidities impact health related quality of life among older adults living with HIV

Alice Zhabokritsky et al. Front Med (Lausanne). .

Abstract

Introduction: The life expectancy of people living with HIV receiving effective combination antiretroviral therapy is approaching that of the general population and non AIDS-defining age-related comorbidities are becoming of greater concern. In order to support healthy aging of this population, we set out to explore the association between multimorbidity (defined as presence of 2 or more non AIDS-defining comorbidities) and quality of life (QoL).

Methods: We performed a cross-sectional analysis using data from the Correlates of Healthy Aging in Geriatric HIV (CHANGE HIV) study, a Canadian cohort of people living with HIV age 65 years and older. Study participants completed two QoL modules, the general QoL and health related QoL (HR-QoL).

Results: 433 participants were included in the analysis with a median age of 69 years (interquartile range, IQR 67-72). The median number of comorbidities among study participants was 3 (IQR 2-4), with 78% meeting the definition of multimorbidity. General QoL scores (median 66, IQR 58-76) were lower than HR-QoL scores (median 71, IQR 61-83) and were not associated with multimorbidity after adjusting for age, sex, relationship status, household income, exercise, tobacco smoking history, malnutrition, time since HIV diagnosis, and HIV-related stigma. In contrast, multimorbidity was associated with lower HR-QoL (adjusted β = -4.57, 95% CI -8.86, -0.28) after accounting for the same variables. Several social vulnerabilities (not having a partner, low household income), health behaviours (lower engagement in exercise, smoking), and HIV-related factors (HIV stigma, longer time since HIV diagnosis) were also associated with lower QoL.

Discussion: Overall, our study demonstrated a high burden of multimorbidity among older adults living with HIV in Canada, which has a negative impact on HR-QoL. Interventions aimed at preventing and managing non-AIDS-defining comorbidities should be assessed in people living with HIV to determine whether this can improve their HR-QoL.

Keywords: HIV; multimorbidity; non-communicable diseases; quality of life; stigma.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Rating of general QoL and HR-QoL domains importance by CHANGE HIV participants, according to age category.
See this image and copyright information in PMC

References

    1. Trickey A, Sabin CA, Burkholder G, Crane H, d'Arminio Monforte A, Egger M, et al. Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studies. Lancet HIV. (2023) 10:e295–307. doi: 10.1016/S2352-3018(23)00028-0, PMID: - DOI - PMC - PubMed
    1. Tseng A, Seet J, Phillips EJ. The evolution of three decades of antiretroviral therapy: challenges, triumphs and the promise of the future. Br J Clin Pharmacol. (2015) 79:182–94. doi: 10.1111/bcp.12403, PMID: - DOI - PMC - PubMed
    1. Deeks SG, Lewin SR, Havlir DV. The end of AIDS: HIV infection as a chronic disease. Lancet. (2013) 382:1525–33. doi: 10.1016/S0140-6736(13)61809-7, PMID: - DOI - PMC - PubMed
    1. Samji H, Cescon A, Hogg RS, Modur SP, Althoff KN, Buchacz K, et al. North American AIDS cohort collaboration on research and design (NA-ACCORD) of IeDEA. Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS One. (2013) 8:e81355. doi: 10.1371/journal.pone.0081355, PMID: - DOI - PMC - PubMed
    1. Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. (2011) 53:1120–6. doi: 10.1093/cid/cir627, PMID: - DOI - PubMed

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