- Traditional risk factors account for a larger burden of non-AIDS-defining cancer, myocardial infarction (MI), and end-stage renal and liver disease vs HIV-related risk factors in HIV-infected, virally suppressed adults.
Why this matters
- HIV viral suppression post-antiretroviral therapy (ART) initiation should be balanced with regular screening for traditional risk factors for non-AIDS-defining cancers, MI, end-stage liver, renal disease/events.
- Consider effective interventions targeted toward non-HIV-related conditions to reduce risk, morbidity.
- 61,500 participants across 21 cohorts.
- Greater number of participants with smoking history, hepatitis C and B, low CD4 cell count (
- Population-attributable fractions (PAFs):
- Non-AIDS-defining cancer: smoking (24%; 95% CI, 13-35); MI (37%; 95% CI, 7-66);
- MI: elevated total cholesterol (44%; 95% CI, 30-58); hypertension (42%; 95% CI, 28-56);
- Liver disease: hepatitis C (30%; 95% CI, 21-39); low CD4 cell count (19%; 95% CI, 12-26);
- Renal disease: hypertension (39%; 95% CI, 26-51).
- Prospective multicohort estimation of proportion of non-AIDS-defining cancers, MI, end-stage liver, renal disease/events attributable to traditional and HIV-related risk factors among HIV-infected US and Canadian adults with successful care linkage.
- Funding: NIH; CDC.
- Potential underestimation of PAFs.
- Additional preventable/modifiable risk factors not considered.
- Causation undetermined.