Prevalence of self-reported comorbidities in HIV positive and HIV negative men who have sex with men over 55 years-The Australian Positive & Peers Longevity Evaluation Study (APPLES)

Abstract

In Australia, almost half of HIV-positive people are now aged over 50 and are predominately gay and bisexual men (GBM). Compared to the general HIV-negative population, GBM engage more in behaviours that may increase the risk of age-related comorbidities, including smoking, high alcohol consumption and recreational drug use. The objective of APPLES was to compare comorbidities and risk factors in HIV-positive older GBM with an appropriate control group of HIV-negative GBM. We undertook a prospectively recruited cross-sectional sample of HIV-positive and HIV-negative GBM ≥ 55 years. Detailed data collection included clinic data, a health and lifestyle survey, and blood sample collection. We report key demographic, laboratory markers and self-reported comorbidities by HIV status. For selected comorbidities we also adjust HIV status a priori for age, smoking and body mass index. Over 16 months 228 HIV-positive and 218 HIV-negative men were recruited. Median age was 63 years (IQR: 59-67). Although more HIV-positive men reported having ever smoked, smoking status was not statistically different between HIV positive and HIV negative men (p = 0.081). Greater alcohol use was reported by HIV-negative men (p = 0.002), and recreational drug use reported more often by HIV-positive men (p<0.001). After adjustment, HIV-positive men had significantly increased odds of diabetes (adjusted Odds ratio (aOR): 1.97, p = 0.038), thrombosis (aOR: 3.08, p = 0.007), neuropathy (aOR: 34.6, P<0.001), and non-significantly increased odds for heart-disease (aOR: 1.71, p = 0.077). In conclusion, HIV-positive GBM have significantly increased odds for key self-reported comorbidities. This study underscores the importance of an appropriate HIV-negative control group for more accurate evaluation of the risk and attribution of age-related comorbidities in HIV-positive people.

Conflict of interest statement

Competing Interests: This study was funded by an unrestricted research grant from Gilead Sciences Australia. The authors have the following potential competing interests to declare. Kathy Petoumenos (KP) and Matthew Law’s (ML) institution has received unrestricted research grants from pharmaceutical consortium: Merck, Sharpe and Dohme, Gilead Sciences, Bristol-Myers Squibb; Boehringer Ingleheim; Janssen-Cilag; ViiV Health Care. KP has also received consultancy fees from ViiV Healthcare. ML has received consultancy fees from Gilead Sciences; DSMB sitting fees from Sirtex Pty Ltd. Jennifer Hoy's institution received funding for her involvement in Advisory Boards for Gilead Sciences, ViiV Health care and Merck, Sharp & Dohme. Mark Bloch has received funding for involvement in Medical Advisory Boards from Gilead Sciences, ViiV Healthcare, Merck, Sharp & Dohme, Bristol Myers-Squibb and Abbvie; support to attend scientific meetings from Gilead Sciences; honoraria for presentations at medical meetings by Gilead Sciences, ViiV Healthcare; Merck Sharp and Dohme; funding to his institution for clinical research from Gilead Sciences, ViiV Healthcare, Merck Sharp and Dohme, Bristol Myers-Squibb, Amgen, Zynerba, Atomo Diagnostics and Eli Lilly. David Baker has received trial funding, conference sponsorship and has participated in advisory board meetings for Gilead, ViiV, Merck and BMS. David Cooper serves on the Gilead Advisory Board. The remaining co-authors have no potential conflicts of interest to declare. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Selected self-reported comorbidities by HIV status.

*denotes (unadjusted) P-value

Fig 2. Number of comorbidities by HIV status and age group.