Project no.: HIV-NAT 207/Aging study
This study will assess the depression, vitamin D deficiency and osteoporosis among aging HIV-infected and HIV-uninfected population in Thailand
Results: Among 357 participants (median [IQR] age of 54.4 [52.2-60.4] years, 37.5% female) enrolled, median CD4 was 614 (477-797) cells/µL, 97.2% had HIV RNA < 40 copies/mL, and the most common ART were TDF (84%) and efavirenz (58.3%). A total of 216 (60.5%) had NCI, and women had higher NCI prevalence than men (70.9% vs 54.3%, p=0.002). Women performed significantly worse than men in visuospatial/executive, naming, attention, language, abstraction, and orientation domains (p< 0.05). More women had education lower than bachelor degree (82.1% vs 61.0%, p< 0.001) and income < 300$/month (52.2% vs 31.8%, p< 0.001); whereas more men had HBV infection (25.1% vs 14.9%, p=0.02), HCV infection (13.1 vs 6%, p=0.03), class C CDC classification (20% vs 9.2%, p=0.007), diabetes mellitus (21.1% vs 9.7%, p=0.005), hypertension (51.1% vs 29.1%, p< 0.001), abnormal cIMT (6.4% vs 1.6%, p=0.042), and lower median CD4 cell counts (599 vs 675 cells/µL, p=0.01). In multivariable regression analysis, women (adjusted odd ratio [aOR] 1.9; 95%CI 1.1-3.6, p=0.019), age ≥60 years (aOR 1.9; 95%CI 1.1-3.4, p=0.03), and education lower than bachelor degree (aOR 2.2; 95%CI 1.3-3.6, p=0.002) were associated with NCI. cIMT and HIV related factors were not associated with NCI.
(Source: Hiransuthikul A., et al., Higher prevalence of neurocognitive impairment among aging HIV-infected women despite lower comorbidities than men. Abstract # TUPEB072. Presented at 22nd International AIDS Conference 2018)
58.25% were males with median age 54 yrs, BMI of 23 kg/m2. In the IR group, hypertension, body mass index (BMI), waist hip ratio, body fat, visceral fat rating, fasting insulin, fasting plasma glucose, triglyceride levels, TG/HDL-C index, TyG index and Mets were significantly higher than in the non-IR group. The median TyG index was significantly different between the IR group (N=84) and non-IR group (N=201), at 9.1 (IQR8.7-9.4) and 8.7 (IQR 8.3-9.1), respectively (P< 0.001). The median TG/HDL-C index was significantly higher among the IR group than non-IR group [4.3 (IQR 2.8-6.3) vs 2.8 (IQR 1.8-4.5); P< 0.001]. The TyG index and TG/HDL-C were well correlated with HOMA-IR (r=0.39; P< 0.001 and r=0.31; P< 0.001, respectively). The TyG index showed a strong positive association with ASCVD (r=0.35; P< 0.001). The cut-off of the TyG index for diagnosis of insulin resistance was 9.0 with sensitivity 0.61 and specificity 0.72. HOMA-IR score increased by 57% for every 1 unit increase in TyG.
(Source: Apornpong T, et al., Triglycerides/glucose index is a simple and clinically useful surrogate for insulin resistance among non-diabetic HIV-infected Aging in Asia. Abstract # TUPEB116. Presented at 22nd International AIDS Conference 2018)
Totally 316 HIV-infected adults (median age 54.4 years, 61% men, 15.8% diabetes, 40.2% hypertension) were included. The median duration of ART was 16.3 years and 32% were currently on boosted PI. The mean overall cIMT of the common carotid arteries were 0.63 (IQR 0.55-0.72) mm. Men had higher cIMT (0.64 (IQR 0.56-0.76) vs 0.60 (IQR 0.53-0.70), p=0.03. Overall, 3.8% had ciMT >0.9 mm and 27.6% had carotid plaque. From the multivariate logistic regression analysis, age [odds ratio (OR) 1.06; 95% confidence interval (CI) 1.003-1.12; p=0.04] and CD4 nadir < 200 cells/mm3 [OR 1.8; 95%CI 1.02-3.18, p=0.04] were significantly associated with subclinical atherosclerosis. ART regimen and hs-CRP were not associated with subclinical atherosclerosis.
(Source: Avihingsanon A, et al., Prevalence and risk factors associated with carotid plaque and intima-medial thickness in virologically suppressed HIV-infected Asians. Abstract # TUPEB101. Presented at 22nd International AIDS Conference 2018)
Among 357 participants (median [IQR] age of 54.4 [52.2-60.4] years, 37.5% female) enrolled, median CD4 was 614 (477-797) cells/µL, 97.2% had HIV RNA < 40 copies/mL, and the most common ART were TDF (84%) and efavirenz (58.3%). A total of 216 (60.5%) had NCI, and women had higher NCI prevalence than men (70.9% vs 54.3%, p=0.002). Women performed significantly worse than men in visuospatial/executive, naming, attention, language, abstraction, and orientation domains (p< 0.05). More women had education lower than bachelor degree (82.1% vs 61.0%, p< 0.001) and income < 300$/month (52.2% vs 31.8%, p< 0.001); whereas more men had HBV infection (25.1% vs 14.9%, p=0.02), HCV infection (13.1 vs 6%, p=0.03), class C CDC classification (20% vs 9.2%, p=0.007), diabetes mellitus (21.1% vs 9.7%, p=0.005), hypertension (51.1% vs 29.1%, p< 0.001), abnormal cIMT (6.4% vs 1.6%, p=0.042), and lower median CD4 cell counts (599 vs 675 cells/µL, p=0.01). In multivariable regression analysis, women (adjusted odd ratio [aOR] 1.9; 95%CI 1.1-3.6, p=0.019), age ≥60 years (aOR 1.9; 95%CI 1.1-3.4, p=0.03), and education lower than bachelor degree (aOR 2.2; 95%CI 1.3-3.6, p=0.002) were associated with NCI. cIMT and HIV related factors were not associated with NCI.
(Source: Hiransuthikul A, et al., Higher prevalence of neurocognitive impairment among aging HIV-infected women despite lower comorbidities than men Abstract # TUPEB072. Presented at 22nd International AIDS Conference 2018)
Participants were male (60%) with median (IQR) age 54.4 (51.9- 58.3) years. Most were non-smokers and reported no alcohol consumption. HIV positive had been taking ART for a median of 16.1 (11.9-19.1) years and 97% had HIV RNA< 50 c/mL. Baseline characteristics amongst study groups were similar, but compared to HIV-negative participants, HIV-positive participants had lower BMI (median 22.8 vs 24.6kg/m2 ), percent body fat (23%VS 25.4%), and visceral fat rating in the high range (26% VS 44%), but higher prevalence of hypertension (HT) (37% VS 20%) and Hepatitis C (10% VS 2%). IR was prevalent in 29% of HIV-positive compared to 16% in HIV-negative participants. In an adjusted model, IR was associated with HIV status (adjusted odds ratio [aOR] 5.22 (95%CI 1.91 – 14.24); P=001), HT (aOR 2.8 (95%CI 1.48-5.28); P=0.002) , hsCRP >3mg/L (aOR 2.35 (95%CI 1.15 – 4.79); P=0.02), high visceral fat scores (aOR 3.87 (95%CI 1.81 – 8.29); P=0.001 and higher liver fibrosis scores (aOR 1.08 (95%CI 1.002 – 1.17); P=0.045). Association of ART regimen and IR was not observed.
(Source: Apornpong T, et al., Higher prevalence of insulin resistance among non diabetes HIV-infected ageing Asian received long term ART compared to HIV uninfected control. Abstract # TUPEB119. Presented at 22nd International AIDS Conference 2018)
