First occurrence of diabetes, chronic kidney disease, and hypertension among north American HIV-infected adults, 2000-2013

Cherise Wong, Stephen J Gange, Kate Buchacz, Richard D Moore, Amy C. Justice, Michael A. Horberg, M. John Gill, John R. Koethe, Peter F. Rebeiro, Michael J. Silverberg, Frank J. Palella, Pragna Patel, Mari M. Kitahata, Heidi M. Crane, Alison Gump Abraham, Hasina Samji, Sonia Napravnik, Tareq Ahmed, Jennifer Thorne, Ronald J. BoschAngel M. Mayor, Keri Althoff

Research output: Contribution to journalArticle

Abstract

Background. There remains concern regarding the occurrence of noncommunicable diseases (NCDs) among individuals aging with human immunodeficiency virus (HIV), but few studies have described whether disparities between demographic subgroups are present among individuals on antiretroviral therapy (ART) with access to care. Methods. We assessed the first documented occurrence of type 2 diabetes mellitus (DM), chronic kidney disease (CKD), and treated hypertension (HTN) by age, sex, and race within the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). HIV-infected adults (>18 years) who initiated ART were observed for first NCD occurrence between 1 January 2000 and 31 December 2013. Cumulative incidences as of age 70 were estimated accounting for the competing risk of death; Poisson regression was used to compare rates of NCD occurrence by demographic subgroup. Results. We included >50 000 persons with >250 000 person-years of follow-up. Median follow-up was 4.7 (interquartile range, 2.4- 8.1) years. Rates of first occurrence (per 100 person-years) were 1.2 for DM, 0.6 for CKD, and 2.6 for HTN. Relative to non-black women, the cumulative incidences were increased in black women (68% vs 51% for HTN, 52% vs 41% for DM, and 38% vs 35% for CKD; all P < .001); this disparity was also found among men (73% vs 60% for HTN, 44% vs 34% for DM, and 30% vs 25% for CKD; all P < .001). Conclusions. Racial disparities in the occurrence of DM, CKD, and HTN emphasize the need for prevention and treatment options for these HIV populations receiving care in North America.

Original languageEnglish (US)
Pages (from-to)459-467
Number of pages9
JournalClinical Infectious Diseases
Volume64
Issue number4
DOIs
StatePublished - Feb 15 2017

Keywords

  • Aging
  • Disparities
  • HIV
  • Noncommunicable disease

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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    Wong, C., Gange, S. J., Buchacz, K., Moore, R. D., Justice, A. C., Horberg, M. A., Gill, M. J., Koethe, J. R., Rebeiro, P. F., Silverberg, M. J., Palella, F. J., Patel, P., Kitahata, M. M., Crane, H. M., Abraham, A. G., Samji, H., Napravnik, S., Ahmed, T., Thorne, J., ... Althoff, K. (2017). First occurrence of diabetes, chronic kidney disease, and hypertension among north American HIV-infected adults, 2000-2013. Clinical Infectious Diseases, 64(4), 459-467. https://doi.org/10.1093/cid/ciw804