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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Depression and human immunodeficiency virus infection are risk factors for incident heart failure among veterans:
Jessica R White1, Chung-Chou H Chang1, Kaku A So-Armah1
1From Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, PA (J.R.W.); Department of Medicine, University of Pittsburgh School of Medicine, PA (C.-C.H.C.); Department of Medicine, Boston University, MA (K.A.S.-A.); Department of Psychology, Indiana University-Purdue University Indianapolis (J.C.S., T.K.); Department of Medicine, Indiana University School of Medicine, Indianapolis (S.K.G.); Hamad Healthcare Quality Institute, Doha, Qatar (A.A.B.); Hamad Medical Corporation, Doha, Qatar (A.A.B.); VA Medical Center, Washington, DC (C.L.G.); Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA (D.R.); Atlanta VA Medical Center, Decatur, GA (D.R.); Infectious Diseases Section, Michael E. DeBakey VAMC and Department of Medicine, Baylor College of Medicine, Houston, TX (M.C.R.-B.); UCLA School of Medicine and Division of General Medicine, Greater Los Angeles VA Healthcare System, CA (D.A.L.); Department of Medicine, VA North Texas Health Care System, Dallas (R.J.B.); Division of Cardiology, University of Maryland Medical Center, Baltimore (J.S.G.); Department of Medical and Clinical Psychology, Tilburg University, The Netherlands (W.J.K.); Department of Medicine, University of Maryland School of Medicine, Baltimore (S.S.G.); Los Angeles Biomedical Research Institute, Torrance, CA (M.J.B.); Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (H.T.); Yale University School of Medicine, New Haven, CT (A.C.J.); Veterans Affairs Connecticut Health Care System, West Haven Veterans Administration Medical Center, CT (A.C.J.); and Cardiovascular Medicine Division, Vanderbilt University School of Medicine and Tennessee Valley Healthcare System, Nashville, TN (M.S.F.).
Major depressive disorder (MDD) significantly increases heart failure (HF) risk in adults with HIV. Managing MDD in HIV-positive individuals is crucial for reducing HF incidence and improving cardiovascular health.
Area of Science:
- Cardiology
- Infectious Diseases
- Psychiatry
Background:
- Both HIV infection and major depressive disorder (MDD) are independently linked to increased heart failure (HF) risk.
- MDD is a common comorbidity in adults with HIV (HIV+), potentially exacerbating HF risk.
Purpose of the Study:
- To assess the association between HIV, MDD, and incident HF in a large cohort.
- To determine if MDD is an independent risk factor for HF in HIV+ adults.
Main Methods:
- Analysis of the Veterans Aging Cohort Study (VACS) including 81,427 participants.
- Categorization into four groups: HIV- without MDD, HIV- with MDD, HIV+ without MDD, and HIV+ with MDD.
- Use of International Classification of Diseases, Ninth Revision codes for MDD and HF diagnosis, with a median follow-up of 5.8 years.
Main Results:
- Heart failure (HF) incidence was highest in HIV+ participants with MDD (9.32 per 1000 person-years).
- HIV+ individuals with MDD showed a significantly higher risk of HF (aHR, 1.68) compared to HIV- without MDD.
- MDD was an independent risk factor for HF in both HIV- (aHR, 1.21) and HIV+ (aHR, 1.29) groups. Antidepressant use was associated with lower HF risk.
Conclusions:
- Major depressive disorder is an independent risk factor for HF in adults with HIV.
- Highlights the critical need for identifying and managing MDD in the HIV+ population.
- Further research is needed to elucidate mechanisms and develop interventions to reduce HF morbidity and mortality.
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