Rate of co-morbidities not related to HIV infection or AIDS among HIV-infected patients, by CD4 count and HAART use status

Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Clinical Infectious Diseases (Impact Factor: 8.89). 10/2008; 47(8):1102-4. DOI: 10.1086/592115
Source: PubMed


The rate of comorbidities not related to human immunodeficiency virus (HIV) infection or acquired immunodeficiency syndrome
(AIDS) among HIV-infected patients may be higher than expected. We assessed the incidence of comorbidities not related to
HIV infection or AIDS by CD4 cell count and highly active antiretroviral therapy (HAART) use status in an HIV clinical practice.
A total of 2824 patients contributed 9172 person-years of longitudinal data during the period 1997–2006. Among patients with
a CD4 cell count <350 cells/mm3, receipt of HAART was associated with a significantly decreased incidence of comorbidities not related to HIV infection or

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    • "Consequently , patterns of morbidity and mortality among HIVinfected subjects receiving ART are changing, with an increase in the proportion of deaths due to non–HIV-related disorders, including cardiovascular disease, liver disease, and non–AIDSdefining cancers [22, 23]. Lower CD4 + T-cell count, anemia, and uncontrolled viral load, along with the classical potentially modifiable risk factors, such as cigarette smoking, diabetes, and hypertension, seem to play a driving role in developing severe non–AIDS-defining events, although available data are partially contrasting [24, 25] . Studies on modifiable and nonmodifiable risk factors for non–AIDS-defining events in HIVinfected persons are still an important unmet research issue. "

    Full-text · Article · Jul 2014
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    • "These include using drugs before sex, IDU, needle sharing, multiple sexual partners, sex with prostitutes, and sex with IDU. Consistent with these findings, many studies that have reported the prevalence of psychosocial problems not only to be common in PLWHA but related to high HIV/AIDS risky behaviors (Farinpour et al., 2003; Cook et al., 2004; Moore et al., 2008; Wyatt et al., 2002; Whetten et al., 2006). "
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    ABSTRACT: Infection with the human immunodeficiency virus (HIV) that causes acquired immunodeficiency syndrome (AIDS) is still rising globally. In order to develop effective HIV/AIDS risky behavior reduction intervention strategies and to further decrease the spread of HIV/AIDS, it is important to assess the prevalence of psychosocial problems and HIV/AIDS risky behaviors in people living with HIV/AIDS (PLWHA). The objective of this study is to assess the relationship between psychosocial variables and HIV/AIDS risky behaviors among PLWHA. A total of 341 questionnaires were distributed and 326 were fully completed and returned, 96% response rate. The relationships between the identified psychosocial and HIV/AIDS risky behaviors among PLWHA were analyzed using The Moment Structures software version 17.0 (SPSS Inc.) The results indicate that psychosocial health problems were significant predictors of HIV/AIDS risky behaviors in PLWA. Further cross-disciplinary research that addresses the manner in which psychosocial problems and HIV/AIDS risky behaviors interact with each other among PLWHA is needed.
    Full-text · Article · Jan 2012
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    ABSTRACT: Serious non-AIDS (SNA) diseases are important causes of morbidity and mortality in the HAART era. We describe development of standard criteria for 12 SNA events for Endpoint Review Committee (ERC) use in START, a multicenter international HIV clinical trial. SNA definitions were developed based upon the following: (1) criteria from a previous trial (SMART), (2) review of published literature, (3) an iterative consultation and review process with the ERC and other content experts, and (4) evaluation of draft SNA criteria using retrospectively collected reports in another trial (ESPRIT). Final criteria are presented for acute myocardial infarction, congestive heart failure, coronary artery disease requiring drug treatment, coronary revascularization, decompensated liver disease, deep vein thrombosis, diabetes mellitus, end-stage renal disease, non-AIDS cancer, peripheral arterial disease, pulmonary embolism, and stroke. Of 563 potential SNA events reported in ESPRIT and reviewed by an ERC, 72% met "confirmed" and 13% "probable" criteria. Twenty-eight percent of cases initially reviewed by the ERC required follow-up discussion (adjudication) before a final decision was reached. HIV clinical trials that include SNA diseases as clinical outcomes should have standardized SNA definitions to optimize event reporting and validation and should have review by an experienced ERC with opportunities for adjudication.
    Full-text · Article · Jul 2010 · HIV Clinical Trials
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