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FREQUENCY OF NON-COMMUNICABLE DISEASES IN PEOPLE 50 YEARS OF AGE AND OLDER RECEIVING HIV CARE IN LATIN AMERICA
Author
Belaunzaran-Zamudio, Pablo F.
Caro-Vega, Yanink
Giganti, Mark J.
Castilho, Jessica L.
Crabtree-Ramirez, Brenda E.
Shepherd, Bryan E.
Mejía, Fernando
Cesar, Carina
Moreira, Rodrigo C.
Wolff, Marcelo
Pape, Jean W.
Padgett, Denis
McGowan, Catherine C.
Sierra-Madero, Juan G.
Caribbean, Central and South American network for HIV epidemiology (CCASAnet)
Caro-Vega, Yanink
Giganti, Mark J.
Castilho, Jessica L.
Crabtree-Ramirez, Brenda E.
Shepherd, Bryan E.
Mejía, Fernando
Cesar, Carina
Moreira, Rodrigo C.
Wolff, Marcelo
Pape, Jean W.
Padgett, Denis
McGowan, Catherine C.
Sierra-Madero, Juan G.
Caribbean, Central and South American network for HIV epidemiology (CCASAnet)
Affilliation
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Vanderbilt University. Department of Biostatistics. Nashville, Tennessee, United States of America.
Vanderbilt University. Department of Medicine. Nashville, Tennessee, United States of America.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Vanderbilt University. Department of Biostatistics. Nashville, Tennessee, United States of America.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Fundación Huesped. Buenos Aires, Argentina.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundación Arriarán. Department of Infectious Diseases. Santiago de Chile, Chile.
Les Centres GHESKIO. Port-au-Prince, Haiti.
Instituto Hondureño de Seguridad Social. Tegucigalpa, Honduras.
Vanderbilt University. Department of Medicine. Nashville, Tennessee, United States of America.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Vanderbilt University. Department of Biostatistics. Nashville, Tennessee, United States of America.
Vanderbilt University. Department of Medicine. Nashville, Tennessee, United States of America.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Vanderbilt University. Department of Biostatistics. Nashville, Tennessee, United States of America.
Universidad Peruana Cayetano Heredia. Instituto de Medicina Tropical Alexander von Humboldt. Lima, Peru.
Fundación Huesped. Buenos Aires, Argentina.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Fundación Arriarán. Department of Infectious Diseases. Santiago de Chile, Chile.
Les Centres GHESKIO. Port-au-Prince, Haiti.
Instituto Hondureño de Seguridad Social. Tegucigalpa, Honduras.
Vanderbilt University. Department of Medicine. Nashville, Tennessee, United States of America.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Departamento de Infectología. Mexico City, Mexico.
Abstract
Background: A growing population of older adults with HIV will increase demands on HIV-related healthcare. Nearly a quarter of people receiving care for HIV in Latin America are currently 50 years or older, yet little is known about the frequency of comorbidities in this population. We estimated the prevalence and incidence of non-communicable diseases (NCDs) among people 50 years of age or older (≥50yo) receiving HIV care during 2000-2015 in six centers affiliated with the Caribbean, Central and South American network for HIV epidemiology (CCASAnet).
Methods: We estimated the annual prevalence, and overall prevalence and incidence of cardiovascular diseases, diabetes, hypertension, dyslipidemia, psychiatric disorders, chronic liver and renal diseases, and non-AIDS-defining cancers, and multimorbidity (more than one NCD) of people ≥50yo receiving care for HIV. Analyses were performed according to age at enrollment into HIV care (<50yo and ≥50yo).
Results: We included 3,415 patients ≥50yo, of whom 1,487(43%) were enrolled at age ≥50 years. The annual prevalence of NCDs increased from 32% to 68% and multimorbidity from 30% to 40% during 2000-2015. At the last registered visit, 53% of patients enrolled <50yo and 50% of those enrolled ≥50yo had at least one NCD. Most common NCDs at the last visit in each age-group at enrollment were dyslipidemia (36% in <50yo and 28% in ≥50yo), hypertension (17% and 18%), psychiatric disorders (15% and 10%), and diabetes (11% and 12%).
Conclusions: The prevalence of NCDs and multimorbidity in people ≥50 years receiving care for HIV in CCASAnet centers in Latin America increased substantially in the last 15 years. Our results make evident the need of planning for provision of complex, primary care for aging adults living with HIV.
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