Human immunodeficiency virus (HIV)-infected patients may have a greater risk of noninfectious
comorbidities (NICMs) compared with the general population. We assessed the prevalence
and risk factors for NICMs in a large cohort of HIV-infected adults and compared these
findings with data from matched control subjects.
We performed a case-control study involving antiretroviral therapy (ART)-experienced
HIV-infected patients treated at Modena University, Italy, from 2002 through 2009.
These patients were compared with age-, sex-, and race-matched adults (control subjects)
from the general population included in the CINECA ARNO database. NICMs included cardiovascular
disease, hypertension, diabetes mellitus, bone fractures, and renal failure. Polypathology
(Pp) was defined as the concurrent presence of ≥2 NICMs. Logistic regression models
were constructed to evaluate associated predictors of NICMs and Pp.
There were 2854 patients and 8562 control subjects. The mean age was 46 years, and
37% were women. Individual NICM and Pp prevalences in each age stratum were higher
among patients than among controls (all P <.001). Pp prevalence among patients aged
41-50 years was similar to that among controls aged 51-60 years (P value was not statistically
significant); diabetes mellitus, cardiovascular disease, bone fractures, and renal
failure were statistically independent after adjustment for sex, age, and hypertension.
Logistic regression models showed that independent predictors of Pp in the overall
cohort were (all P < .001) age (odds ratio [OR], 1.11), male sex (OR, 1.77), nadir
CD4 cell count <200 cells/μL (OR, 4.46), and ART exposure (OR, 1.01).
Specific age-related NICMs and Pp were more common among HIV-infected patients than
in the general population. The prevalence of Pp in HIV-infected persons anticipated
Pp prevalence observed in the general population among persons who were 10 years older,
and HIV-specific cofactors (lower nadir CD4 cell count and more prolonged ART exposure)
were identified as risk factors. These data support the need for earlier screening
for NICMs in HIV-infected patients.