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 G. Abraham, Hasina Samji, Sonia Napravnik, Tareq Ahmed, Jennifer E. Thorne, Ronald J. Bosch & 2 others Angel M. Mayor, Keri N. 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.

LanguageEnglish (US)
Pages459-467
Number of pages9
JournalClinical Infectious Diseases
Volume64
Issue number4
DOIs
StatePublished - Feb 15 2017

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Chronic Renal Insufficiency
HIV
Hypertension
Diabetes Mellitus
Demography
Incidence
North America
Type 2 Diabetes Mellitus
Acquired Immunodeficiency Syndrome
Research Design
Therapeutics
Population

Keywords

  • Aging
  • Disparities
  • HIV
  • Noncommunicable disease

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

First occurrence of diabetes, chronic kidney disease, and hypertension among north American HIV-infected adults, 2000-2013. / Wong, Cherise; Gange, Stephen J.; Buchacz, Kate; Moore, Richard D.; Justice, Amy C.; Horberg, Michael A.; Gill, M. John; Koethe, John R.; Rebeiro, Peter F.; Silverberg, Michael J.; Palella, Frank J.; Patel, Pragna; Kitahata, Mari M.; Crane, Heidi M.; Abraham, Alison G.; Samji, Hasina; Napravnik, Sonia; Ahmed, Tareq; Thorne, Jennifer E.; Bosch, Ronald J.; Mayor, Angel M.; Althoff, Keri N.

In: Clinical Infectious Diseases, Vol. 64, No. 4, 15.02.2017, p. 459-467.

Research output: Contribution to journalArticle

Wong, C, Gange, SJ, Buchacz, K, Moore, RD, Justice, AC, Horberg, MA, Gill, MJ, Koethe, JR, Rebeiro, PF, Silverberg, MJ, Palella, FJ, Patel, P, Kitahata, MM, Crane, HM, Abraham, AG, Samji, H, Napravnik, S, Ahmed, T, Thorne, JE, Bosch, RJ, Mayor, AM & Althoff, KN 2017, 'First occurrence of diabetes, chronic kidney disease, and hypertension among north American HIV-infected adults, 2000-2013' Clinical Infectious Diseases, vol 64, no. 4, pp. 459-467. DOI: 10.1093/cid/ciw804
Wong, Cherise ; Gange, Stephen J. ; Buchacz, Kate ; Moore, Richard D. ; Justice, Amy C. ; Horberg, Michael A. ; Gill, M. John ; Koethe, John R. ; Rebeiro, Peter F. ; Silverberg, Michael J. ; Palella, Frank J. ; Patel, Pragna ; Kitahata, Mari M. ; Crane, Heidi M. ; Abraham, Alison G. ; Samji, Hasina ; Napravnik, Sonia ; Ahmed, Tareq ; Thorne, Jennifer E. ; Bosch, Ronald J. ; Mayor, Angel M. ; Althoff, Keri N./ First occurrence of diabetes, chronic kidney disease, and hypertension among north American HIV-infected adults, 2000-2013. In: Clinical Infectious Diseases. 2017 ; Vol. 64, No. 4. pp. 459-467
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AU - Buchacz,Kate

AU - Moore,Richard D.

AU - Justice,Amy C.

AU - Horberg,Michael A.

AU - Gill,M. John

AU - Koethe,John R.

AU - Rebeiro,Peter F.

AU - Silverberg,Michael J.

AU - Palella,Frank J.

AU - Patel,Pragna

AU - Kitahata,Mari M.

AU - Crane,Heidi M.

AU - Abraham,Alison G.

AU - Samji,Hasina

AU - Napravnik,Sonia

AU - Ahmed,Tareq

AU - Thorne,Jennifer E.

AU - Bosch,Ronald J.

AU - Mayor,Angel M.

AU - Althoff,Keri N.

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N2 - 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.

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KW - Disparities

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KW - Noncommunicable disease

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