Emerging non-AIDS comorbidities among adults with and without perinatally-acquired HIV.

Abstract

Background: Individuals with perinatally acquired HIV (PHIV) who age into adulthood may be at risk for the early development of specific non-AIDS associated comorbidities (NAC). It is unclear whether the early initiation of ART among PHIV may decrease risk for the development of specific NAC.

Methods: This retrospective study examined NAC outcomes among a cohort of PHIV and an age range-matched cohort of people with non-perinatally acquired HIV (NPHIV). Multivariate logistic regression models examined the association between clinical/demographic predictors and NAC and the association between early vs. late ART initiation and development of NAC among PHIV. Log rank test was used to compare Kaplan-Meier curves for NAC outcomes.

Results: Compared to NPHIV (N=173), PHIV (N=171) significantly differed by age (30.1 vs 31.8 yrs), tobacco use, lower CD4 nadir, and with less HIV viral suppression. Both groups had high rates of HTN (PHIV 38.5%, NPHIV 29.5%), ≥stage 3 CKD (PHIV 5.9%, NPHIV 1.73%), hypercholesterolemia, and asthma. PHIV demonstrated higher likelihood of hypertension (OR 1.87, 95%CI 1.1-3.2), chronic kidney disease (OR 6.95, 95%CI 1.7-29.7), and a non-significant trend towards higher likelihood of death. PHIV had significantly earlier acquisition of HTN, and CKD. Rates of NAC among patients within the PHIV cohort did not differ based on early vs. late ART initiation.

Conclusions: Compared to NPHIV of similar age, PHIV adults had higher rates of HTN and CKD and were more likely to acquire these diseases at a younger age than NPHIV. These findings may have long term implications for cardiovascular risk among aging PHIV.