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, Moustapha Dramé, Cyrille Delpierre, Clotilde Allavena, André Cabié, Lise Cuzin, David Rey, Pascal Pugliese, Guy Hédelin, Firouzé Bani-Sadr, 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, Maxime Hentzien, Moustapha Dramé, Cyrille Delpierre, Clotilde Allavena, André Cabié, Lise Cuzin, David Rey, Pascal Pugliese, Guy Hédelin, Firouzé Bani-Sadr, 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

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.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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