Multimorbidity in Elderly Persons According to the Year of Diagnosis of Human Immunodeficiency Virus Infection: A Cross-sectional Dat’AIDS Cohort Study
Authors: Demontès Marie , Eymard Duvernay Sabrina , Allavena Clotilde , Jovelin Thomas , Reynes Jacques , Hentzien Maxime , Ravaux Isabelle , Delobel Pierre , Bregigeon Sylvie , Rey David , Ferry Tristan , Gagneux-Brunon Amandine , Robineau Olivier , Pugliese Pascal , Duvivier Claudine , Cabié André , Chirouze Catherine , Jacomet Christine , Lamaury Isabelle , Merrien Dominique , Hoen Bruno , Hocqueloux Laurent , Cheret Antoine , Katlama Christine , Arvieux Cédric , Krolak-Salmon Pierre , Makinson Alain ,   Dat’AIDS Study Group, Drobacheff-Thiébaut C , Foltzer A , Bouiller K , Hustache- Mathieu L , Chirouze C , Lepiller Q , Bozon F , Babre O , Brunel S A , Muret P , Laurichesse H , Lesens O , Vidal M , Mrozek N , Aumeran C , Baud O , Corbin V , Letertre-Gibert P , Casanova S , Prouteau J , Jacomet C , Lamaury I , Fabre I , Curlier E , Ouissa R , Herrmann-Storck C , Tressieres B , Bonijoly T , Receveur C M , Boulard F , Daniel C , Clavel C , Merrien D , Perré P , Guimard T , Bollangier O , Leautez S , Morrier M , Laine L , Ader F , Becker A , Biron F , Boibieux A , Cotte L , Ferry T , Miailhes P , Perpoint T , Roux S , Triffault-Fillit C , Degroodt S , Brochier C , Valour F , Chidiac C , Ménard A , Belkhir Y A , Colson P , Dhiver C , Madrid A , Martin-Degiovani M , Meddeb L , Mokhtari M , Motte A , Raoux A , Ravaux I , Tamalet C , Toméi C , Tissot Dupont H , Brégigeon S , Zaegel-Faucher O , Obry-Roguet V , Laroche H , Orticoni M , Soavi J M , Geneau de Lamarlière P , Ressiot E , Ducassou J M , Jaquet I , Galie S , Galinier A , Martinet P , Landon M , Ritleng S A , Ivanova A , Debreux C , Lions C , Poizot-Martin I , Abel S , Cabras O , Cuzin L , Guitteaud K , Illiaquer M , Pierre-François S , Osei L , Pasquier J , Rome K , Sidani E , Turmel M J , Varache C , Cabié A , Atoui N , Bistoquet M , Delaporte E , Le Moing V , Makinson A , Meftah N , Merle de Boever C , Montes B , Montoya Ferrer A , Tuaillon E , Reynes J , André M , Boyer L , Bouillon P M , Delestan M , Rabaud C , May T , Hoen B , Allavena C , Bernaud C , Billaud E , Biron C , Bonnet B , Bouchez S , Boutoille D , Brunet-Cartier C , Deschanvres C , Hall N , Jovelin T , Morineau P , Reliquet V , Sécher S , Cavellec M , Soria A , Ferré V , André-Garnier E , Rodallec A , Lefebvre M , Grossi O , Aubry O , Raffi F , Pugliese P , Breaud S , Ceppi C , Chirio D , Cua E , Dellamonica P , Demonchy E , De Monte A , Durant J , Etienne C , Ferrando S , Garraffo R , Michelangeli C , Mondain V , Naqvi A , Oran N , Perbost I , Pillet S , Pradier C , Prouvost-Keller B , Risso K , Rio V , Roger P M , Rosenthal E , Sausse S , Touitou I , Wehrlen-Pugliese S , Zouzou G , Hocqueloux L , Prazuck T , Gubavu C , Sève A , Maka A , Boulard C , Thomas G , Cheret A , Goujard C , Quertainmont Y , Teicher E , Lerolle N , Deradji O , Barrail-Tran A , Landman R , Joly V , Ghosn J , Rioux C , Lariven S , Gervais A , Lescure F X , Matheron S , Louni F , Julia Z , Mackoumbou-Nkouka C , Le Gac S , Charpentier C , Descamps D , Peytavin G , Yazdanpanah Y , Amazzough K , Avettand-Fenoël V , Benabdelmoumen G , Bossi P , Cessot G , Charlier C , Consigny P H , Danion F , Dureault A , Duvivier C , Goesch J , Guery R , Henry B , Jidar K , Lanternier F , Loubet P , Lortholary O , Louisin C , Lourenco J , Parize P , Pilmis B , Touam F , Valantin M A , Tubiana R , Agher R , Seang S , Schneider L , Palich R , Blanc C , Katlama C , Berger J L , N’Guyen Y , Lambert D , Kmiec I , Hentzien M , Brunet A , Brodard V , Bani-Sadr F , Tattevin P , Revest M , Souala F , Baldeyrou M , Patrat-Delon S , Chapplain J M , Benezit F , Dupont M , Poinot M , Maillard A , Pronier C , Lemaitre F , Guennoun C , Poisson-Vanier M , Jovelin T , Sinteff J P , Arvieux C , Botelho-Nevers E , Gagneux-Brunon A , Frésard A , Ronat V , Lucht F , Fischer P , Partisani M , Cheneau C , Priester M , Batard L M , Bernard-Henry C , de Mautort E , Fafi-Kremer S , Rey D , Alvarez M , Biezunski N , Debard A , Delpierre C , Lansalot P , Lelièvre L , Martin-Blondel G , Piffaut M , Porte L , Saune K , Delobel P , Ajana F , Aïssi E , Alcaraz I , Baclet V , Bocket L , Boucher A , Choisy P , Huleux T , Lafon-Desmurs B , Meybeck A , Pradier M , Robineau O , Viget N , Valette M 
Published: December 2019

Abstract

Background
We assessed prevalence of multimorbidity (MM) according to year of human immunodeficiency virus (HIV) diagnosis in elderly people living with HIV (PLWH).

Methods
This was a cross-sectional study of MM in PLWH aged ≥70 years from the Dat’AIDS French multicenter cohort. MM was defined as at least 3 coexistent morbidities of high blood pressure, diabetes mellitus, osteoporosis, non-AIDS cancer, chronic renal failure, cardiovascular and cerebrovascular disease, obesity, undernutrition, or hypercholesterolemia. Logistic regression models evaluated the association between MM and calendar periods of HIV diagnosis (1983–1996, 1997–2006, and 2007–2018). The secondary analysis evaluated MM as a continuous outcome, and a sensitivity analysis excluded PLWH with nadir CD4 count &lt;200 cells/μL.

Results
Between January 2017 and September 2018, 2476 PLWH were included. Median age was 73 years, 75% were men, median CD4 count was 578 cells/μL, and 94% had controlled viremia. MM prevalence was 71%. HBP and hypercholesterolemia were the most prevalent comorbidities. After adjustment for age, gender, smoking status, hepatitis C and hepatitis B virus coinfection, group of exposure, nadir CD4 count, CD4:CD8 ratio, and last CD4 level, calendar period of diagnosis was not associated with MM (P = .169). MM was associated with older age, CD4/CD8 ratio &lt;0.8, and nadir CD4 count &lt;200 cells/μL. Similar results were found with secondary and sensitivity analyses.

Conclusions
MM prevalence was high and increased with age, low CD4/CD8 ratio, and nadir CD4 count &lt;200 cells/μL but was not associated with calendar periods of HIV diagnosis. Known duration of HIV diagnosis does not seem to be a criterion for selecting elderly PLWH at risk of MM.