2024
The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study.
Althoff K, Stewart C, Humes E, Gerace L, Boyd C, Gebo K, Justice A, Hyle E, Coburn S, Lang R, Silverberg M, Horberg M, Lima V, Gill M, Karris M, Rebeiro P, Thorne J, Rich A, Crane H, Kitahata M, Rubtsova A, Wong C, Leng S, Marconi V, D'Souza G, Kim H, Napravnik S, McGinnis K, Kirk G, Sterling T, Moore R, Kasaie P. The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study. PLOS Medicine 2024, 21: e1004325. PMID: 38215160, PMCID: PMC10833859, DOI: 10.1371/journal.pmed.1004325.Peer-Reviewed Original ResearchConceptsHistory of injection drug useInjection drug useHealthcare needsPrevalence of comorbiditiesHIV diagnosisNorth American AIDS Cohort CollaborationDrug useAntiretroviral therapyHIV surveillance dataGuideline-recommended careNon-Hispanic whitesPrevalence of anxietyChronic kidney diseaseMyocardial infarctionPrevalence of cancerEnd-stage liver diseaseResearch and DesignMultimorbidity prevalenceRisk of comorbiditiesUnited StatesBlack MSMNon-HispanicSubspecialty careClinical capacityHIV clinicians
2022
Predictive Risk Model for Serious Falls Among Older Persons Living With HIV
Womack JA, Murphy TE, Leo-Summers L, Bates J, Jarad S, Smith AC, Gill TM, Hsieh E, Rodriguez-Barradas MC, Tien PC, Yin MT, Brandt CA, Justice AC. Predictive Risk Model for Serious Falls Among Older Persons Living With HIV. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2022, 91: 168-174. PMID: 36094483, PMCID: PMC9470988, DOI: 10.1097/qai.0000000000003030.Peer-Reviewed Original ResearchConceptsMiddle-aged veteransOlder PWHAntiretroviral therapySerious fallsOlder personsVeterans Aging Cohort StudyMeasures of multimorbidityAging Cohort StudyBody mass indexMultivariable logistic regressionPredictive risk modelCohort studyMass indexInjury codesElevated riskGeneral populationSix monthsPWHLogistic regressionPotential predictorsSubstance useRadiology reportsHIVExternal causesVeteransTenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV
Li G, Park LS, Lodi S, Logan RW, Cartwright EJ, Aoun-Barakat L, Casas JP, Dickerman BA, Rentsch CT, Justice AC, Hernán MA. Tenofovir disoproxil fumarate and coronavirus disease 2019 outcomes in men with HIV. AIDS 2022, 36: 1689-1696. PMID: 35848570, PMCID: PMC9444875, DOI: 10.1097/qad.0000000000003314.Peer-Reviewed Original ResearchConceptsTDF/FTCTenofovir disoproxil fumarateCoronavirus disease 2019 (COVID-19) outcomesTAF/FTCAntiretroviral therapyTenofovir alafenamideDisoproxil fumarateRisk ratioAcute respiratory syndrome coronavirus 2 infectionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionCOVID-19 ICU admissionsIntensive care unit admissionPrevious COVID-19 diagnosisSyndrome coronavirus 2 infectionCOVID-19-related hospitalizationVeterans Aging Cohort StudySARS-CoV-2 infectionCare unit admissionCoronavirus 2 infectionChronic kidney diseaseHIV viral loadGlomerular filtration rateAging Cohort StudyCorresponding risk ratioPooled logistic regressionPeriods of Homelessness Linked to Higher VACS Index Among HIV-Positive People Who Use Drugs
Reddon H, Socias ME, Justice A, Cui Z, Nosova E, Barrios R, Fairbairn N, Marshall BDL, Milloy M. Periods of Homelessness Linked to Higher VACS Index Among HIV-Positive People Who Use Drugs. AIDS And Behavior 2022, 26: 1739-1749. PMID: 35064852, PMCID: PMC9150923, DOI: 10.1007/s10461-021-03524-1.Peer-Reviewed Original ResearchConceptsHIV disease progressionART adherenceDisease progressionAntiretroviral therapyVeterans Aging Cohort Study (VACS) IndexVACS Index scoreSignificant risk factorsHIV-positive peopleVACS IndexCause mortalityProspective cohortRisk factorsMortality riskIndex scoreStudy indicesAdherenceProgressionLongitudinal relationshipHIVImpact of homelessnessPWUDUnregulated drugsAssociationDrugsFuture studies
2021
The shifting age distribution of people with HIV using antiretroviral therapy in the United States
Althoff KN, Stewart CN, Humes E, Zhang J, Gerace L, Boyd CM, Wong C, Justice AC, Gebo KA, Thorne JE, Rubtsova AA, Horberg MA, Silverberg MJ, Leng SX, Rebeiro PF, Moore RD, Buchacz K, Kasaie P. The shifting age distribution of people with HIV using antiretroviral therapy in the United States. AIDS 2021, 36: 459-471. PMID: 34750289, PMCID: PMC8795488, DOI: 10.1097/qad.0000000000003128.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyRace/ethnicityNorth American AIDS Cohort CollaborationHIV acquisition riskHIV Epidemic goalsOverall median ageSubgroups of sexRelative reductionAge distributionCohort CollaborationHIV diagnosisMedian ageRisk groupsUS CentersAcquisition riskHIVUS populationDisease controlSurveillance reportsBrief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV?
Womack JA, Murphy TE, Ramsey C, Bathulapalli H, Leo-Summers L, Smith AC, Bates J, Jarad S, Gill TM, Hsieh E, Rodriguez-Barradas MC, Tien PC, Yin MT, Brandt C, Justice AC. Brief Report: Are Serious Falls Associated With Subsequent Fragility Fractures Among Veterans Living With HIV? JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 88: 192-196. PMID: 34506360, PMCID: PMC8513792, DOI: 10.1097/qai.0000000000002752.Peer-Reviewed Original ResearchConceptsSubsequent fragility fracturesFragility fracturesAntiretroviral therapySerious fallsRisk factorsVeterans Aging Cohort StudyAging Cohort StudyMultivariable logistic regressionUpper arm fracturesMiddle-aged populationYears of ageAlcohol use disorderCohort studyHip fractureVertebral fracturesArm fracturesInjury codesICD9 codesGeneral populationUse disordersLogistic regressionIntegrase inhibitorsOlder adultsRadiology reportsHIVPolypharmacy-associated risk of hospitalisation among people ageing with and without HIV: an observational study
Justice AC, Gordon KS, Romero J, Edelman EJ, Garcia BJ, Jones P, Khoo S, Re V, Rentsch CT, Tate JP, Tseng A, Womack J, Jacobson D. Polypharmacy-associated risk of hospitalisation among people ageing with and without HIV: an observational study. The Lancet Healthy Longevity 2021, 2: e639-e650. PMID: 34870254, PMCID: PMC8639138, DOI: 10.1016/s2666-7568(21)00206-3.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyMedication countDrug-drug interactionsAntiretroviral therapyObservational studyPhysiological frailtyVeterans Affairs Health Services ResearchMore drug-drug interactionsRisk of hospitalisationRisk of admissionAging Cohort StudyHIV-1 RNANon-ART medicationsAdverse health outcomesNational InstituteHealth services researchAdditional medicationObserved medicationActive medicationCause mortalityMore medicationsCohort studyPrescription fillsHIV statusPrescription medicationsCD4+ cell count and outcomes among HIV-infected compared with uninfected medical ICU survivors in a national cohort
Akgün KM, Krishnan S, Butt AA, Gibert CL, Graber CJ, Huang L, Pisani MA, Rodriguez-Barradas MC, Hoo GWS, Justice AC, Crothers K, Tate JP. CD4+ cell count and outcomes among HIV-infected compared with uninfected medical ICU survivors in a national cohort. AIDS 2021, 35: 2355-2365. PMID: 34261095, PMCID: PMC8563390, DOI: 10.1097/qad.0000000000003019.Peer-Reviewed Original ResearchAssociation between HIV infection and hypertension: a global systematic review and meta-analysis of cross-sectional studies
Davis K, Perez-Guzman P, Hoyer A, Brinks R, Gregg E, Althoff KN, Justice AC, Reiss P, Gregson S, Smit M. Association between HIV infection and hypertension: a global systematic review and meta-analysis of cross-sectional studies. BMC Medicine 2021, 19: 105. PMID: 33980222, PMCID: PMC8117497, DOI: 10.1186/s12916-021-01978-7.Peer-Reviewed Original ResearchConceptsHIV-negative individualsCross-sectional studyHIV statusHypertension riskPrevalent hypertensionRisk ratioObservational studyGlobal systematic reviewSystematic reviewEffective antiretroviral therapyHIV-negative controlsNon-communicable diseasesStudy-level factorsDifferent risk factorsRandom-effects modelHypertension differsAntiretroviral therapyHypertension preventionHIV infectionCochrane CENTRALRisk factorsHypertensionPLHIVMAIN OUTCOMEHigh riskNIH Workshop on HIV-Associated Comorbidities, Coinfections, and Complications: Summary and Recommendation for Future Research.
Pahwa S, Deeks S, Zou S, Tomitch N, Miller-Novak L, Caler E, Justice A, Sacktor N, Gabuzda D, Hunt PW, Brown T, Kurth A, Baral S, Mugavero M, Mayer KH, Mendenhall E, Detels R, Mutabazi V. NIH Workshop on HIV-Associated Comorbidities, Coinfections, and Complications: Summary and Recommendation for Future Research. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 86: 11-18. PMID: 33306561, PMCID: PMC7982002, DOI: 10.1097/qai.0000000000002528.Peer-Reviewed Original ResearchConceptsPotent antiretroviral therapyImplementation science researchBasic science researchAIDS comorbiditiesAntiretroviral therapyMiddle-income countriesClinical researchHealthy agingSyndemics researchHealth spanNIH workshopComorbiditiesComplicationsHIVPWHNormal lifespanCoinfectionIncome countriesNIHPressing gapsPotential prioritiesInvestigatorsPopulation researchRegimensWG members
2020
Polypharmacy and frailty among persons with HIV
Sung M, Gordon K, Edelman EJ, Akgün KM, Oursler KK, Justice AC. Polypharmacy and frailty among persons with HIV. AIDS Care 2020, 33: 1492-1499. PMID: 32880183, PMCID: PMC7925692, DOI: 10.1080/09540121.2020.1813872.Peer-Reviewed Original ResearchConceptsNon-ARV medicationsVeterans Aging Cohort StudyFrailty-related phenotypeLow physical activityAging Cohort StudyCross-sectional studyWarrants further studyUninfected participantsAntiretroviral therapyCohort studyRefill dataAdjusted analysisViral loadPolypharmacyPhysical activityGeneral populationMedicationsPLWHFrailtyStrong associationFurther studiesHIVPrimary predictorAssociationLarge proportionTiming of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus
Silverberg MJ, Leyden W, Hernández-Ramírez RU, Qin L, Lin H, Justice AC, Hessol NA, Achenbach CJ, D’Souza G, Engels EA, Althoff KN, Mayor AM, Sterling TR, Kitahata MM, Bosch RJ, Saag MS, Rabkin CS, Horberg MA, Gill MJ, Grover S, Mathews WC, Li J, Crane HM, Gange SJ, Lau B, Moore RD, Dubrow R, Neugebauer RS. Timing of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus. Clinical Infectious Diseases 2020, 72: 1900-1909. PMID: 32785640, PMCID: PMC8315132, DOI: 10.1093/cid/ciaa1046.Peer-Reviewed Original ResearchConceptsVirus-related cancersEarly antiretroviral therapyHuman immunodeficiency virusAntiretroviral therapyART initiationImmunodeficiency virusNorth American AIDS Cohort CollaborationART-naive PLWHEarly ART initiationAntiretroviral therapy initiationHIV transmission riskNon-Hodgkin lymphomaCancer registry linkageRisk of cancerMarginal structural modelsRace/ethnicityCohort CollaborationTherapy initiationChart reviewIncident cancerRegistry linkageViral hepatitisTime-dependent confoundingCancer groupViral etiologyAlcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence?
Williams EC, McGinnis KA, Rubinsky AD, Matson TE, Bobb JF, Lapham GT, Edelman EJ, Satre DD, Catz SL, Richards JE, Bryant KJ, Marshall BDL, Kraemer KL, Crystal S, Gordon AJ, Skanderson M, Fiellin DA, Justice AC, Bradley KA. Alcohol Use and Antiretroviral Adherence Among Patients Living with HIV: Is Change in Alcohol Use Associated with Change in Adherence? AIDS And Behavior 2020, 25: 203-214. PMID: 32617778, PMCID: PMC7775874, DOI: 10.1007/s10461-020-02950-x.Peer-Reviewed Original ResearchConceptsAlcohol useAntiretroviral therapyLow-level alcohol useInitial adherenceAntiretroviral adherenceAdherence interventionsAdherence decreasesAlcohol use increasesScreening scoresLongitudinal associationsAdherencePLWHHIVAnnual changesLinear regression modelsStable scoresRegression modelsScoresSmall annual changesDynamic longitudinal associationsAssociationUse increasesPatientsTherapy
2019
Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV), and HIV/HCV Coinfection
Hanberg JS, Freiberg MS, Goetz MB, Rodriguez-Barradas MC, Gibert C, Oursler KA, Justice AC, Tate JP. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Prognostic Inflammatory Biomarkers in Human Immunodeficiency Virus (HIV), Hepatitis C Virus (HCV), and HIV/HCV Coinfection. Open Forum Infectious Diseases 2019, 6: ofz347. PMID: 31660334, PMCID: PMC6786514, DOI: 10.1093/ofid/ofz347.Peer-Reviewed Original ResearchHuman immunodeficiency virusVACS Index 2.0Veterans Aging Cohort StudyAddition of NLRHepatic decompensationLymphocyte ratioHepatitis C virusInflammatory biomarkersImmunodeficiency virusHepatitis C virus statusHIV/HCV coinfectionC virus statusPrognostic inflammatory biomarkerSoluble CD-14Strong unadjusted associationsAging Cohort StudyBiomarkers of inflammationPoor health outcomesMortality risk indexHCV coinfectionAntiretroviral therapyCohort studyBiomarker cohortD-dimerPrognostic indexEffect estimates in randomized trials and observational studies: comparing apples with apples
Lodi S, Phillips A, Lundgren J, Logan R, Sharma S, Cole SR, Babiker A, Law M, Chu H, Byrne D, Horban A, Sterne JAC, Porter K, Sabin C, Costagliola D, Abgrall S, Gill J, Touloumi G, Pacheco AG, van Sighem A, Reiss P, Bucher HC, Giménez A, Jarrin I, Wittkop L, Meyer L, Perez-Hoyos S, Justice A, Neaton JD, Hernán MA. Effect estimates in randomized trials and observational studies: comparing apples with apples. American Journal Of Epidemiology 2019, 188: 1569-1577. PMID: 31063192, PMCID: PMC6670045, DOI: 10.1093/aje/kwz100.Peer-Reviewed Original ResearchComparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people
Torgersen J, So-Armah K, Freiberg MS, Goetz MB, Budoff MJ, Lim JK, Taddei T, Butt AA, Rodriguez-Barradas MC, Justice AC, Kostman JR, Lo Re V. Comparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people. BMC Gastroenterology 2019, 19: 52. PMID: 30987601, PMCID: PMC6466708, DOI: 10.1186/s12876-019-0969-1.Peer-Reviewed Original ResearchConceptsAdvanced hepatic fibrosisSeverity of steatosisHepatic steatosisHIV infectionHIV statusHepatic fibrosisLiver attenuationCardiovascular diseaseSteatosis severityUninfected individualsGreater severityVeterans Aging Cohort StudyNoncontrast abdominal CTAging Cohort StudySpleen attenuation ratioHepatic steatosis severityCross-sectional studyMultivariable linear regressionUninfected participantsAntiretroviral therapyCohort studyAbdominal CTUninfected personsOverall prevalenceRisk factorsImproved discrimination of mortality with Veterans Aging Cohort Study (VACS) Index 2.0 in HIV-positive individuals
Tate JP, Sterne JAC, Justice AC. Improved discrimination of mortality with Veterans Aging Cohort Study (VACS) Index 2.0 in HIV-positive individuals. AIDS 2019, Publish Ahead of Print: &na;. PMID: 30649058, PMCID: PMC6749990, DOI: 10.1097/qad.0000000000002140.Peer-Reviewed Original ResearchConceptsWhite blood countC-statisticBlood countVeterans Aging Cohort Study (VACS) IndexAntiretroviral Therapy Cohort CollaborationDiscrimination of mortalityVACS Index 2.0Antiretroviral therapy initiationCD4 cell countHIV-positive populationHarrell's C-statisticHIV-1 RNAHIV-positive individualsKaplan-Meier plotsCohort CollaborationNadir CD4VAC patientsAntiretroviral therapyCause mortalityCD8 ratioTherapy initiationViral suppressionGeneral healthExcess mortalityLaboratory valuesEmulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV‐positive individuals
Caniglia EC, Robins JM, Cain LE, Sabin C, Logan R, Abgrall S, Mugavero MJ, Hernández‐Díaz S, Meyer L, Seng R, Drozd DR, Seage G, Bonnet F, Le Marec F, Moore RD, Reiss P, Sighem A, Mathews WC, Jarrín I, Alejos B, Deeks SG, Muga R, Boswell SL, Ferrer E, Eron JJ, Gill J, Pacheco A, Grinsztejn B, Napravnik S, Jose S, Phillips A, Justice A, Tate J, Bucher HC, Egger M, Furrer H, Miro JM, Casabona J, Porter K, Touloumi G, Crane H, Costagliola D, Saag M, Hernán MA. Emulating a trial of joint dynamic strategies: An application to monitoring and treatment of HIV‐positive individuals. Statistics In Medicine 2019, 38: 2428-2446. PMID: 30883859, PMCID: PMC6499640, DOI: 10.1002/sim.8120.Peer-Reviewed Original ResearchConceptsHIV-positive individualsCopies/First-line treatment regimenAIDS Research NetworkAIDS-free survivalCells/Integrated Clinical SystemsHIV-CAUSAL CollaborationOutcomes of interestRisk difference estimatesDirect effectAntiretroviral therapyHIV RNACD4 thresholdTreatment regimenNew regimenTreatment strategiesHIV researchTarget trialsRegimenTherapyResearch NetworkTrialsSurvivalClinical systemsAssociation of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study
Hernández-Ramírez RU, Qin L, Lin H, Leyden W, Neugebauer RS, Althoff KN, Achenbach CJ, Hessol NA, D'Souza G, Gebo KA, Gill MJ, Grover S, Horberg MA, Li J, Mathews WC, Mayor AM, Park LS, Rabkin CS, Salters K, Justice AC, Moore RD, Engels EA, Silverberg MJ, Dubrow R, AIDS N, Betts A, Brooks J, Freeman A, Van Rompaey S, Burchell A, Yip B, You B, Hogan B, Grasso C, Hogg R, Benson C, Drozd D, Sterling T, Haas D, Humes E, Crane H, Willig J, Eron J, Martin J, Saag M, Jing J, Zhang J, Lindsay J, Hunter-Mellado R, Deeks S, Zhu J, Montaner J, McReynolds J, Gabler K, Buchacz K, Rodriguez B, Thorne J, Margolick J, Anastos K, Jacobson L, Klein M, Kroch A, Morton L, Turner M, Fiellin D, Gange S, Mugavero M, Harrigan P, Rebeiro P, Bosch R, Kirk G, Mayer K, McKaig R, Coburn S, Napravnik S, Kitahata M, Lober W, Lee J. Association of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study. The Lancet HIV 2019, 6: e240-e249. PMID: 30826282, PMCID: PMC6531288, DOI: 10.1016/s2352-3018(18)30360-6.Peer-Reviewed Original ResearchConceptsNon-Hodgkin lymphomaRecent CD4 countCD4 countHIV viraemiaKey independent predictorsViral loadIndependent predictorsNorth American AIDS Cohort CollaborationCNS non-Hodgkin's lymphomaOverall non-Hodgkin lymphomaDiffuse large B-cell lymphomaLarge B-cell lymphomaAssociation of immunosuppressionMulticentre cohort studyNon-Hodgkin lymphoma (NHL) riskAverage viral loadUS Health ResourcesB-cell lymphomaOverall immune functionB cell activationLong-term careCohort CollaborationRecent immunosuppressionAntiretroviral therapyCohort study
2018
Herpes Zoster and Herpes Zoster Vaccine Rates Among Adults Living With and Without HIV in the Veterans Aging Cohort Study
Hawkins KL, Gordon KS, Levin MJ, Weinberg A, Battaglia C, Rodriguez-Barradas MC, Brown ST, Rimland D, Justice A, Tate J, Erlandson KM. Herpes Zoster and Herpes Zoster Vaccine Rates Among Adults Living With and Without HIV in the Veterans Aging Cohort Study. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 79: 527-533. PMID: 30179984, PMCID: PMC6203599, DOI: 10.1097/qai.0000000000001846.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyHerpes zoster ratesHerpes zosterAging Cohort StudyUninfected adultsUninfected veteransVaccine receiptZoster vaccineCohort studyHIV serostatusStudy periodCART-treated individualsCombination antiretroviral therapyHIV-1 RNAHigh rateLow CD4Vaccine guidelinesZoster vaccinationAntiretroviral therapyVaccine ratesStudy endPharmacy dataEffective vaccinePLWHZoster