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The 'COmorBidity in Relation to AIDS' (COBRA) cohort: Design, methods and participant characteristics
Davide De Francesco1, Ferdinand W Wit2,3, James H Cole4
1University College London, London, United Kingdom.
Insights
People with HIV on combination antiretroviral therapy (cART) may age faster and develop age-associated non-communicable comorbidities (AANCC) earlier. The COBRA study investigates this link in middle-aged individuals with HIV and controls.
Area of Science:
- Gerontology and HIV Medicine
- Epidemiology of Chronic Diseases
Background:
- Individuals with HIV on combination antiretroviral therapy (cART) may experience accelerated aging and earlier onset of age-associated non-communicable comorbidities (AANCC).
- The potential causal link between HIV infection and AANCC requires further investigation.
Purpose of the Study:
- To investigate the potential causal link between HIV and AANCC.
- To examine accelerated aging in individuals with HIV on cART compared to HIV-negative controls.
Main Methods:
- A longitudinal cohort study (COBRA) involving middle-aged HIV-positive individuals with sustained viral suppression on cART and age-matched HIV-negative controls.
- Participants were recruited from European HIV treatment centers and sexual health clinics, with assessments at baseline and after a 2-year follow-up.
Main Results:
- The study recruited 134 HIV-positive individuals (median age 56) and 79 HIV-negative controls (median age 57).
- Both cohorts were predominantly male, of white ethnicity, and men who have sex with men (MSM).
Conclusions:
- The COBRA study provides valuable data on the relationship between HIV and AANCC.
- Findings will inform the development of prognostic tools for early AANCC diagnosis and novel interventions to prevent comorbidities in people with HIV.
Background:
Persons living with HIV on combination antiretroviral therapy (cART) may be at increased risk of the development of age-associated non-communicable comorbidities (AANCC) at relatively young age. It has therefore been hypothesised that such individuals, despite effective cART, may be prone to accelerated aging.
Objective:
The COmorBidity in Relation to AIDS (COBRA) cohort study was designed to investigate the potential causal link between HIV and AANCC, amongst others, in a cohort of middle-aged individuals with HIV with sustained viral suppression on cART and otherwise comparable HIV-negative controls.
Methods:
Longitudinal cohort study of HIV-positive subjects ≥45 years of age, with sustained HIV suppression on cART recruited from two large European HIV treatment centres and similarly-aged HIV-negative controls recruited from sexual health centres and targeted community groups. Both HIV-positive and HIV-negative subjects were assessed at study entry and again at follow-up after 2 years.
Results:
Of the 134 HIV-positive individuals with a median (IQR) age of 56 (51, 62) years recruited, 93% were male, 88% of white ethnicity and 86% were men who have sex with men (MSM). Similarly, the 79 HIV-negative subjects had a median (IQR) age of 57 (52, 64) and 92% were male, 97% of white ethnicity and 80% were MSM.
Conclusions:
The results from the COBRA study will be a significant resource to understand the link between HIV and AANCC and the pathogenic mechanisms underlying this link. COBRA will inform future development of novel prognostic tools for earlier diagnosis of AANCC and of novel interventions which, as an adjunct to cART, may prevent AANCC.