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Antiretroviral exposure and comorbidities in an aging HIV-infected population: The challenge of geriatric patients

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  • معلومة اضافية
    • Contributors:
      Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes (Hôpital Hôtel-Dieu de Nantes - CHU de Nantes); Biostatistique, Biomathématique, Pharmacoépidémiologie et Maladies Infectieuses (B2PHI); Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut Pasteur Paris (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM); CeGIDD Strasbourg; Centre d'infectiologie Necker-Pasteur CHU Necker; Institut Pasteur Paris (IP)-Hôpital Necker - Enfants Malades AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Centre Médical de l'Institut Pasteur (CMIP); Institut Pasteur Paris (IP); Infection à VIH, réservoirs, diversité génétique et résistance aux antirétroviraux (ARV) (EA 7327); Université Paris Descartes - Paris 5 (UPD5); Université de Reims Champagne-Ardenne (URCA); Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD); Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM); Université de Clermont-Ferrand; Hôpital l'Archet; Centre Hospitalier Universitaire de Toulouse (CHU Toulouse); CHU Pitié-Salpêtrière AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); AP-HP - Hôpital Bichat - Claude Bernard Paris; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)); Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM); Université Claude Bernard Lyon 1 (UCBL); Université de Lyon; Université des Antilles - UFR des sciences médicales Hyacinthe Bastaraud (UA UFR SM); Université des Antilles (UA); Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée); Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy); Département Maladies Infectieuses et Tropicales CHRU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques et émergentes (TransVIHMI); Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I (UY1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Cheikh Anta Diop de Dakar Sénégal (UCAD); Université Jean Monnet - Saint-Étienne (UJM); Université de Franche-Comté (UFC); Université Bourgogne Franche-Comté COMUE (UBFC); Hôpital de Tourcoing; Université des Antilles (Pôle Martinique)
    • بيانات النشر:
      CCSD
      Public Library of Science
    • الموضوع:
      2018
    • Collection:
      Université de Lyon: HAL
    • نبذة مختصرة :
      International audience ; As HIV-infected adults on successful antiretroviral therapy (ART) are expected to have close to normal lifespans, they will increasingly develop age-related comorbidities. The objective of this cross-sectional study was to compare in the French Dat’AIDS cohort, the HIV geriatric population, aged 75 years and over, to the elderly one, aged from 50 to 74 years. As of Dec 2015, 16,436 subjects (43.8% of the French Dat’AIDS cohort) were aged from 50 to 74 (elderly group) and 572 subjects (1.5%) were aged 75 and over (geriatric group). Durations of HIV infection and of ART were slightly but significantly different, median at 19 and 18 years, and 15 and 16 years in the elderly and geriatric group, respectively. The geriatric group was more frequently at CDC stage C and had a lower nadir CD4. This group had been more exposed to first generation protease inhibitors and thymidine analogues. Despite similar virologic suppression, type of ART at the last visit significantly differed between the 2 groups: triple ART in 74% versus 68.2%, ART ≥ 4 drugs in 4.7% versus 2.7%; dual therapy in 11.6% versus 16.4% in the elderly group and the geriatric group, respectively. In the geriatric group all co-morbidities were significantly more frequent, except dyslipidemia, 4.3% of the elderly group had ≥4 co-morbidities versus18.4% in the geriatric group. Despite more co-morbidities and more advanced HIV infection the geriatric population achieve similar high rate of virologic suppression than the elderly population. A multidisciplinary approach should be developed to face the incoming challenge of aging HIV population.
    • الرقم المعرف:
      10.1371/journal.pone.0203895
    • الدخول الالكتروني :
      https://amu.hal.science/hal-02146850
      https://amu.hal.science/hal-02146850v1/document
      https://amu.hal.science/hal-02146850v1/file/journal.pone.0203895.pdf
      https://doi.org/10.1371/journal.pone.0203895
    • Rights:
      https://creativecommons.org/licenses/by/4.0/ ; info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.E7D09441