Reduced kidney function, high blood pressure and cardiovascular disease have each become more common in a large cohort of Italians living with HIV followed since 2004, with a majority of people now having high cholesterol and high blood pressure, researchers from the Italian ICONA cohort report in HIV Medicine. By 2014, half of all people followed since 2004 were at high risk of a major cardiovascular event such as a stroke or heart attack.
The researchers say that the dramatic increase in the prevalence of non-communicable diseases usually attributed to ageing requires special attention.
More than half of all deaths in people taking antiretroviral therapy (ART) are due to non-communicable diseases such as non-AIDS-defining cancers, cardiovascular disease, or end-stage liver or kidney disease. Many of these conditions are a consequence of growing older but can also be exacerbated by HIV infection, so they may occur at a younger age, or at greater frequency, in people living with HIV.
These co-morbidities also complicate the prescribing of antiretroviral drugs and any medications needed to treat other health conditions, due to drug-drug interactions. People with more co-morbid conditions are more likely to be at risk of unexpected drug-drug interactions if their doctors are unaware of all potential drug interactions.
To examine whether co-morbid conditions are becoming more common in people living with HIV as they age, Italian investigators looked at the prevalence of these conditions in two cross-sectional analyses, in 2004 and 2014, in a closed cohort. They also looked at the prevalence of these conditions according to HIV treatment history in an open cohort, to see whether a lack of treatment – or more prolonged treatment – had any impact on the prevalence of co-morbidities.