2024
DNA methylation‐based telomere length is associated with HIV infection, physical frailty, cancer, and all‐cause mortality
Liang X, Aouizerat B, So‐Armah K, Cohen M, Marconi V, Xu K, Justice A. DNA methylation‐based telomere length is associated with HIV infection, physical frailty, cancer, and all‐cause mortality. Aging Cell 2024, 23: e14174. PMID: 38629454, PMCID: PMC11258465, DOI: 10.1111/acel.14174.Peer-Reviewed Original ResearchCancer prevalenceAll-cause mortalityVeterans Aging Cohort Study Biomarker CohortMortality riskPhysiological frailtyVACS IndexIncreased risk of all-cause mortalityRisk of all-cause mortalityCancer registry dataHigher cancer prevalenceHIV infectionElectronic medical recordsSelf-reported raceCoronary heart diseaseAssociated with HIV infectionIndicator of cellular agingPhysical frailtyRegistry dataSmoking statusWomen's Interagency HIV Study cohortAlcohol consumptionShorter TLTelomere lengthMedical recordsPeripheral blood mononuclear cells
2022
Epigenetic Age Acceleration Markers Are Associated With Physiologic Frailty and All-Cause Mortality in People With Human Immunodeficiency Virus
Oursler KK, Marconi VC, Wang Z, Xu K, Montano M, So-Armah K, Justice AC, Sun YV. Epigenetic Age Acceleration Markers Are Associated With Physiologic Frailty and All-Cause Mortality in People With Human Immunodeficiency Virus. Clinical Infectious Diseases 2022, 76: e638-e644. PMID: 35970820, PMCID: PMC10169393, DOI: 10.1093/cid/ciac656.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusPhysiologic frailtyVACS IndexCause mortalityMortality discriminationImmunodeficiency virusAge accelerationEpigenetic age accelerationVeterans Aging Cohort Study (VACS) IndexWhite blood cell samplesVACS Index 2.0VACS Index scoreNon-Hispanic blacksIntrinsic epigenetic age accelerationExtrinsic epigenetic age accelerationEpigenome-wide DNA methylationBlood cell samplesHazard ratioOne-year increaseCox regressionMean ageC-statisticIndex scoreMortalityStudy indicesPeriods 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
2020
DNA methylation biomarker selected by an ensemble machine learning approach predicts mortality risk in an HIV-positive veteran population
Shu C, Justice AC, Zhang X, Marconi VC, Hancock DB, Johnson EO, Xu K. DNA methylation biomarker selected by an ensemble machine learning approach predicts mortality risk in an HIV-positive veteran population. Epigenetics 2020, 16: 741-753. PMID: 33092459, PMCID: PMC8216205, DOI: 10.1080/15592294.2020.1824097.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyMortality risk groupsAging Cohort StudyHigher mortality riskMortality riskRisk groupsCohort studyHigh mortality risk groupLow-mortality risk groupsInflammation response pathwayHIV-positive participantsHuman immunodeficiency virusLow-risk groupImproved life expectancyVACS IndexHIV populationNatural killerImmunodeficiency virusPredictive biomarkersPLWHDNA methylation biomarkersVeteran populationSurvival analysisEpigenome-wide associationHIVDNA methylation mediates the effect of cocaine use on HIV severity
Shu C, Justice AC, Zhang X, Wang Z, Hancock DB, Johnson EO, Xu K. DNA methylation mediates the effect of cocaine use on HIV severity. Clinical Epigenetics 2020, 12: 140. PMID: 32928285, PMCID: PMC7491141, DOI: 10.1186/s13148-020-00934-1.Peer-Reviewed Original ResearchConceptsHIV-positive participantsHIV severityVACS IndexCocaine useCocaine effectsVeterans Aging Cohort Study Biomarker CohortVeterans Aging Cohort Study (VACS) IndexEpigenome-wide associationHuman immunodeficiency virus (HIV) progressionHigher VACS indexFrequent cocaine useCandidate CpG sitesPersistent cocaine useMendelian randomization analysisHIV outcomesBiomarker cohortHIV progressionVirus progressionVAC indexVeteran populationAntiviral responseCandidate mediatorsStudy indicesMR analysisSeverityThe Veterans Aging Cohort Study (VACS) Index Predicts Mortality in a Community-recruited Cohort of People With Human Immunodeficiency Virus (HIV) Who Use Illicit Drugs
Reddon H, Grant C, Nosova E, Fairbairn N, Barrios R, Justice AC, Nolan S, Socias ME, Milloy MJ. The Veterans Aging Cohort Study (VACS) Index Predicts Mortality in a Community-recruited Cohort of People With Human Immunodeficiency Virus (HIV) Who Use Illicit Drugs. Clinical Infectious Diseases 2020, 73: 538-541. PMID: 32857842, PMCID: PMC8496478, DOI: 10.1093/cid/ciaa1263.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusVeterans Aging Cohort Study (VACS) IndexHuman immunodeficiency virus (HIV) disease severityStudy indicesCommunity-recruited cohortIllicit drugsVirus disease severityVACS IndexProspective cohortImmunodeficiency virusClinical biomarkersDisease severityStudy periodCohortMortalityDrugsIndexBiomarkersSeverityAre we missing opioid-related deaths among people with HIV?
Becker WC, Gordon KS, Edelman EJ, Goulet JL, Kerns RD, Marshall BDL, Fiellin DA, Justice AC, Tate JP. Are we missing opioid-related deaths among people with HIV? Drug And Alcohol Dependence 2020, 212: 108003. PMID: 32417360, PMCID: PMC9580216, DOI: 10.1016/j.drugalcdep.2020.108003.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyOpioid useOverdose deathsLife-limiting conditionsUnnatural deathsGreater oddsAging Cohort StudyVACS IndexOpioid exposureCohort studyHIV infectionHIV statusRisk factorsOdds ratioDeath filesIndex causeHIVDisease severityDeathDecedentsIllicit useDifferential misclassificationOddsCauseOpioids
2019
Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty
Justice A, Tate J. Strengths and Limitations of the Veterans Aging Cohort Study Index as a Measure of Physiologic Frailty. AIDS Research And Human Retroviruses 2019, 35: 1023-1033. PMID: 31565954, PMCID: PMC7133454, DOI: 10.1089/aid.2019.0136.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort Study (VACS) IndexPhysiologic frailtyStudy indicesRoutine clinical laboratory testsClinical laboratory testsVACS IndexCause mortalityFragility fracturesHIV infectionFunctional declineCognitive declineSerious fallsFrailtyRelated outcomesEarly indicatorMortalityLaboratory testsIndexDeliriumHospitalizationPneumoniaHIVInfection
2018
Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals
Justice AC, Gordon KS, Skanderson M, Edelman EJ, Akgün KM, Gibert CL, Re V, Rimland D, Womack JA, Wyatt CM, Tate JP, Team V. Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals. AIDS 2018, 32: 739-749. PMID: 29543653, PMCID: PMC5868488, DOI: 10.1097/qad.0000000000001756.Peer-Reviewed Original ResearchConceptsAdverse health outcomesHIV statusUninfected individualsVACS IndexMedication countUS Veterans Affairs Healthcare SystemHealth outcomesVeterans Affairs Healthcare SystemRisk of hospitalizationSeverity of illnessHIV-1 RNAHIV-positive individualsRisk of mortalityDose responseRace/ethnicityPolypharmacyFiscal year 2009HospitalizationMedicationsMortalityHealthcare systemAntiretroviralsOutcomesAssociationRiskMarkers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV
Triplette M, Justice A, Attia EF, Tate J, Brown ST, Goetz MB, Kim JW, Rodriguez-Barradas MC, Hoo GWS, Wongtrakool C, Akgün K, Crothers K. Markers of chronic obstructive pulmonary disease are associated with mortality in people living with HIV. AIDS 2018, 32: 487-493. PMID: 29135579, PMCID: PMC6366454, DOI: 10.1097/qad.0000000000001701.Peer-Reviewed Original ResearchConceptsChronic obstructive pulmonary diseaseObstructive pulmonary diseaseRisk of deathStudy participantsVACS IndexPulmonary diseaseComputed tomographyImpact of COPDVeterans Aging Cohort Study (VACS) IndexMultivariable Cox regression modelsBurden of comorbiditiesPredictors of mortalityPulmonary function testingCox regression modelMedian followUninfected subjectsAirflow obstructionCohort studyPulmonary functionPulmonary variablesFunction testingMultivariable modelPLWHCT characteristicsMortality rate
2017
White Blood Count, Albumin, and BMI Enhance VACS Index Prognostic Model, but Nadir CD4 and CD8 Metrics Do Not
Tate J, Brown S, Gibert C, Goetz M, Marconi V, Oursler K, Rimland D, Rodriguez-Barradas M, Justice A. White Blood Count, Albumin, and BMI Enhance VACS Index Prognostic Model, but Nadir CD4 and CD8 Metrics Do Not. Open Forum Infectious Diseases 2017, 4: s210-s210. PMCID: PMC5631891, DOI: 10.1093/ofid/ofx163.415.Peer-Reviewed Original ResearchWhite blood countAbsolute neutrophil countBody mass indexNadir CD4VACS IndexBlood countC-statisticVeterans Aging Cohort Study (VACS) IndexCD4/CD8 ratioLong-term viral suppressionKaplan-Meier plotsAvailable clinical dataDeciles of riskART initiationCD8 ratioViral suppressionNeutrophil countMass indexVA careClinical managementDisease burdenClinical dataExternal cohortLaboratory valuesRisk scoreAssociation of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men
Adams JW, Bryant KJ, Edelman J, Fiellin DA, Gaither JR, Gordon AJ, Gordon KS, Kraemer KL, Mimiaga MJ, Operario D, Tate JP, van den Berg JJ, Justice AC, Marshall BDL. Association of Cannabis, Stimulant, and Alcohol use with Mortality Prognosis Among HIV-Infected Men. AIDS And Behavior 2017, 22: 1341-1351. PMID: 28887669, PMCID: PMC5881942, DOI: 10.1007/s10461-017-1905-4.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyLow-risk alcohol useRisk alcohol useMortality riskAlcohol useStimulant useAdjusted longitudinal analysesAging Cohort StudyUnhealthy alcohol useAssociation of cannabisVACS IndexCause mortalityCohort studyPatient populationPrognostic indicatorMortality prognosisHIVStudy periodSubstance useCannabisRiskLongitudinal analysisMenMortalityStimulantsLong-term alcohol use patterns and HIV disease severity
Marshall BDL, Tate JP, McGinnis KA, Bryant KJ, Cook RL, Edelman EJ, Gaither JR, Kahler CW, Operario D, Fiellin DA, Justice AC. Long-term alcohol use patterns and HIV disease severity. AIDS 2017, 31: 1313-1321. PMID: 28492393, PMCID: PMC5596310, DOI: 10.1097/qad.0000000000001473.Peer-Reviewed Original ResearchConceptsHIV disease severityVeterans Aging Cohort StudyHigh-risk drinkersDisease severityAlcohol useRisk drinkersLower riskAlcohol use trajectoriesIndex groupModerate riskIndex trajectoriesVeterans Health Administration sitesAging Cohort StudyHigh-risk groupMeasures of morbidityAlcohol Use Disorders IdentificationLow index groupAlcohol consumption trajectoriesUse trajectoriesSubset of participantsAlcohol use patternsVACS IndexCause mortalityCohort studyProspective cohort
2016
Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients
Edelman EJ, Maisto SA, Hansen NB, Cutter CJ, Dziura J, Fiellin LE, O'Connor PG, Bedimo R, Gibert C, Marconi VC, Rimland D, Rodriguez-Barradas MC, Simberkoff MS, Justice AC, Bryant KJ, Fiellin DA. Protocol for three parallel multi-site stepped care effectiveness studies for unhealthy alcohol use in HIV-positive patients. Contemporary Clinical Trials 2016, 52: 80-90. PMID: 27876616, PMCID: PMC5253227, DOI: 10.1016/j.cct.2016.11.008.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol use disorderHIV-positive patientsMotivational enhancement therapyAlcohol useWeek 12Risk drinkingWeek 4Effective evidence-based treatmentsInfectious disease clinicHIV-positive individualsModerate alcohol useEvidence-based treatmentsParticipants meeting criteriaImplementation of interventionsVACS IndexHIV careSecondary outcomesCare trialsDisease clinicHIV morbidityPrimary outcomeAlcohol pharmacotherapyInitial treatmentLiver diseaseAssociation of chronic obstructive pulmonary disease with frailty measurements in HIV-infected and uninfected Veterans
Akgün KM, Tate JP, Oursler KK, Crystal S, Leaf DA, Womack JA, Brown TT, Justice AC, Crothers K. Association of chronic obstructive pulmonary disease with frailty measurements in HIV-infected and uninfected Veterans. AIDS 2016, 30: 2185-2193. PMID: 27191979, DOI: 10.1097/qad.0000000000001162.Peer-Reviewed Original ResearchConceptsUninfected participantsVACS IndexHIV statusPhysical activityChronic obstructive pulmonary disease (COPD) prevalenceChronic obstructive pulmonary diseasePhysical limitation scaleLow physical activityObstructive pulmonary diseaseCross-sectional studyPhysiologic frailtyUninfected veteransCOPD managementFrailty measurementPulmonary diseaseUnadjusted analysesLimitation ScalePhysiologic biomarkersCOPDFunctional limitationsHIVUninfected individualsClinical biomarkersSelf-report survey itemsDisease prevalenceBaseline, Time-Updated, and Cumulative HIV Care Metrics for Predicting Acute Myocardial Infarction and All-Cause Mortality
Salinas JL, Rentsch C, Marconi VC, Tate J, Budoff M, Butt AA, Freiberg MS, Gibert CL, Goetz MB, Leaf D, Rodriguez-Barradas MC, Justice AC, Rimland D. Baseline, Time-Updated, and Cumulative HIV Care Metrics for Predicting Acute Myocardial Infarction and All-Cause Mortality. Clinical Infectious Diseases 2016, 63: 1423-1430. PMID: 27539575, PMCID: PMC5106607, DOI: 10.1093/cid/ciw564.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionIncident acute myocardial infarctionVeterans Aging Cohort StudyCombination antiretroviral therapyCardiovascular risk factorsHIV-1 RNAVACS IndexHazard ratioMyocardial infarctionRisk factorsMultivariable proportional hazards modelsVACS Index scoreLast clinic visitAging Cohort StudyHuman immunodeficiency virusProportional hazards modelCART initiationAntiretroviral therapyCause mortalityCD4 countClinic visitsCohort studyOrgan injuryPrimary outcomeImmunodeficiency virus
2015
Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia
Barakat LA, Juthani-Mehta M, Allore H, Trentalange M, Tate J, Rimland D, Pisani M, Akgün KM, Goetz MB, Butt AA, Rodriguez-Barradas M, Duggal M, Crothers K, Justice AC, Quagliarello VJ. Comparing clinical outcomes in HIV‐infected and uninfected older men hospitalized with community‐acquired pneumonia. HIV Medicine 2015, 16: 421-430. PMID: 25959543, PMCID: PMC5015437, DOI: 10.1111/hiv.12244.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaVeterans Aging Cohort StudyVACS IndexCAP outcomesAntiretroviral therapyOlder adultsHigher VACS indexDays of dischargeAging Cohort StudyUninfected participantsCohort studyMean LOSHIV infectionLonger LOSClinical outcomesUnadjusted analysesUninfected groupMultivariable modelEligibility criteriaHIVMale veteransMortality rateART useMortalityOutcomesWeight Change After Antiretroviral Therapy and Mortality
Yuh B, Tate J, Butt AA, Crothers K, Freiberg M, Leaf D, Logeais M, Rimland D, Rodriguez-Barradas MC, Ruser C, Justice AC. Weight Change After Antiretroviral Therapy and Mortality. Clinical Infectious Diseases 2015, 60: 1852-1859. PMID: 25761868, PMCID: PMC4542664, DOI: 10.1093/cid/civ192.Peer-Reviewed Original ResearchConceptsBaseline body mass indexVeterans Aging Cohort StudyNormal weight patientsART initiationWeight gainWeight changeHuman immunodeficiency virus-infected patientsLower mortalityDisease severityAntiretroviral therapy initiationMultivariable Cox modelVirus-infected patientsAging Cohort StudyMedian weight changeBody mass indexYears of ARTGreater disease severityVACS IndexAntiretroviral therapyTherapy initiationBaseline weightCohort studyObese patientsSurvival benefitHemoglobin levels
2014
An Adapted Frailty-Related Phenotype and the VACS Index as Predictors of Hospitalization and Mortality in HIV-Infected and Uninfected Individuals
Akgün KM, Tate JP, Crothers K, Crystal S, Leaf DA, Womack J, Brown TT, Justice AC, Oursler KK. An Adapted Frailty-Related Phenotype and the VACS Index as Predictors of Hospitalization and Mortality in HIV-Infected and Uninfected Individuals. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 67: 397-404. PMID: 25202921, PMCID: PMC4213242, DOI: 10.1097/qai.0000000000000341.Peer-Reviewed Original ResearchConceptsHIV-1 RNAUndetectable HIV-1 RNAVACS IndexUninfected individualsHazard ratioC-statisticFrailty-related phenotypePredictors of hospitalizationCohort Study participantsLow physical activityAdverse health outcomesPhysiologic reserveGeriatric syndromesFrailty stateRisk factorsHospitalizationPhysical activityMortality riskHIVHealth behaviorsHealth outcomesSurvival analysisSystem biomarkersStudy participantsMortalityThe VACS Index Accurately Predicts Mortality and Treatment Response among Multi-Drug Resistant HIV Infected Patients Participating in the Options in Management with Antiretrovirals (OPTIMA) Study
Brown ST, Tate JP, Kyriakides TC, Kirkwood KA, Holodniy M, Goulet JL, Angus BJ, Cameron DW, Justice AC, . The VACS Index Accurately Predicts Mortality and Treatment Response among Multi-Drug Resistant HIV Infected Patients Participating in the Options in Management with Antiretrovirals (OPTIMA) Study. PLOS ONE 2014, 9: e92606. PMID: 24667813, PMCID: PMC3965438, DOI: 10.1371/journal.pone.0092606.Peer-Reviewed Original ResearchConceptsVACS IndexCombination antiretroviral therapyNet reclassification improvementHIV biomarkersCause mortalityC-statisticTreatment interventionsMulti-drug resistant HIVHarrel's c-statisticsRespective hazard ratiosKaplan-Meier estimatesProportional hazards modelImproved scoresAntiretroviral studiesAntiretroviral therapyHazard ratioResistant HIVReclassification improvementRestricted IndexTreatment responseStudy interventionRisk scoreHazards modelVAC indexMortality