The effects of age on associations between markers of HIV progression and markers of metabolic function including albumin, haemoglobin and lipid concentrations

Title: The effects of age on associations between markers of HIV progression and markers of metabolic function including albumin, haemoglobin and lipid concentrations
Author(s): Samuel, M
Jose, S
Winston, A
Nelson, M
Johnson, M
Chadwick, D
Fisher, M
Leen, C
Gompels, M
Gilson, R
Post, FA
Hay, P
Sabin, CA
Item Type: Journal Article
Abstract: Objectives We investigated whether age modified associations between markers of HIV progression, CD4 T lymphocyte count and HIV RNA viral load (VL), and the following markers of metabolic function: albumin, haemoglobin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Methods A retrospective analysis of data from the United Kingdom Collaborative HIV Cohort was carried out. Analyses were limited to antiretroviral-naïve subjects to focus on the impact of HIV disease itself. A total of 16670 subjects were included in the analysis. Multilevel linear regression models assessed associations between CD4 count/VL and each of the outcomes. Statistical tests for interactions assessed whether associations differed among age groups. Results After adjustment for gender and ethnicity, there was evidence that lower CD4 count and higher VL were associated with lower TC, LDL-C, haemoglobin and albumin concentrations but higher triglyceride concentrations. Age modified associations between CD4 count and albumin (P < 0.001) and haemoglobin (P = 0.001), but not between CD4 count and HDL-C, LDL-C and TC, or VL and any outcome. Among participants aged < 30, 30–50 and > 50 years, a 50 cells/μL lower CD4 count correlated with a 2.4 [95% confidence interval (CI) 1.7–3.0], 3.6 (95% CI 3.2–4.0) and 5.1 (95% CI 4.0–6.1) g/L lower haemoglobin concentration and a 0.09 (95% CI 0.07–0.11), 0.12 (95% CI 0.11–0.13) and 0.16 (95% CI 0.13–0.19) g/L lower albumin concentration, respectively. Conclusions We present evidence that age modifies associations between CD4 count and plasma albumin and haemoglobin levels. A given reduction in CD4 count was associated with a greater reduction in haemoglobin and albumin concentrations among older people living with HIV. These findings increase our understanding of how the metabolic impact of HIV is influenced by age.
Publication Date: 19-Nov-2013
Date of Acceptance: 12-Sep-2013
URI: http://hdl.handle.net/10044/1/40147
DOI: http://dx.doi.org/10.1111/hiv.12103
ISSN: 1464-2662
Publisher: Wiley
Start Page: 311
End Page: 316
Journal / Book Title: HIV Medicine
Volume: 15
Issue: 5
Copyright Statement: © 2013 The Authors. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
HIV
haemoglobin
lipid metabolism
albumin
ageing
IMMUNODEFICIENCY-VIRUS-INFECTION
AIDS
INDIVIDUALS
COHORT
HIV
ageing
albumin
haemoglobin
lipid metabolism
Adult
Age Factors
Aged
Aging
Albumins
Biomarkers
CD4 Lymphocyte Count
Cholesterol
Disease Progression
Female
Great Britain
HIV Infections
Hemoglobins
Humans
Male
Middle Aged
Regression Analysis
Retrospective Studies
Viral Load
UK Collaborative HIV Cohort Study
Humans
HIV Infections
Disease Progression
Cholesterol
Albumins
Hemoglobins
Biological Markers
CD4 Lymphocyte Count
Viral Load
Regression Analysis
Retrospective Studies
Age Factors
Aging
Adult
Aged
Middle Aged
Great Britain
Female
Male
Virology
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Department of Medicine
Faculty of Medicine



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