- Head and heart in treated HIV infection
M. van der Valk
- Award date
- 27 January 2017
- Number of pages
- Document type
- PhD thesis
- Faculty of Medicine (AMC-UvA)
The introduction of combination antiretroviral therapy (cART) in 1996 changed HIV infection from an inevitably fatal condition into a chronic manageable disease. During the last decade however, concerns have been raised about the increasingly important role of non-AIDS comorbidities as causes of death in cART-treated patients and a potential excess prevalence of non-AIDS comorbidities among HIV-infected individuals.
As most published studies lacked a comparable HIV-uninfected control group, it remained unclear whether or not certain comorbidities were truly occurring more often and/or at a younger age in the HIV-infected population, and if so, whether this excess risk was attributable to HIV-related factors.
To obtain more insight into these issues, the AGEhIV Cohort Study was set up in 2010 in Amsterdam, The Netherlands. This prospective cohort study was designed to compare the prevalence, incidence and risk factors of non-AIDS/ageing-associated comorbidities and organ dysfunction among HIV-infected individuals and highly similar HIV-uninfected controls.
This thesis is based on cross-sectional analyses of baseline data gathered through the AGEhIV Cohort Study and focuses on two prominent and concerning non-AIDS/ageing-associated comorbidities in the context of chronic treated HIV infection: vascular complications (‘heart’) and cognitive impairment (‘head’).
We have shown many non-AIDS/ageing-associated comorbidities, especially vascular complications, to be more prevalent among HIV-infected participants as compared to uninfected controls. Two categories of risk factors towards comorbidity consistently surface, namely immune deficiency and metabolic/vascular factors. Avoiding, modifying, or treating these factors is therefore of great importance to minimize the risk of developing comorbidity in the long term.
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