2024
Hypertension Control During the Coronavirus Disease 2019 Pandemic
Korves C, Peixoto A, Lucas B, Davies L, Weinberger D, Rentsch C, Vashi A, Young-Xu Y, King J, Asch S, Justice A. Hypertension Control During the Coronavirus Disease 2019 Pandemic. Medical Care 2024, 62: 196-204. PMID: 38284412, PMCID: PMC10922611, DOI: 10.1097/mlr.0000000000001971.Peer-Reviewed Original ResearchConceptsHypertension controlFollow-up intervalPrimary care clinic visitsFollow-up lengthVeterans Health AdministrationControlled hypertensionUncontrolled hypertensionGeneralized estimating equationsCohort of individualsStudy inclusion criteriaHealth careHealth AdministrationLonger follow-up intervalsBlood pressure measurementsAssessed associationsClinic visitsInclusion criteriaDecreased likelihoodEstimating equationsPrepandemic periodLow likelihoodCoronavirus diseaseFollow-upHypertensionIndividuals
2023
Genetic Underpinnings of the Transition From Alcohol Consumption to Alcohol Use Disorder: Shared and Unique Genetic Architectures in a Cross-Ancestry Sample
Kember R, Vickers-Smith R, Zhou H, Xu H, Jennings M, Dao C, Davis L, Sanchez-Roige S, Justice A, Gelernter J, Vujkovic M, Kranzler H. Genetic Underpinnings of the Transition From Alcohol Consumption to Alcohol Use Disorder: Shared and Unique Genetic Architectures in a Cross-Ancestry Sample. American Journal Of Psychiatry 2023, 180: 584-593. PMID: 37282553, PMCID: PMC10731616, DOI: 10.1176/appi.ajp.21090892.Peer-Reviewed Original ResearchAssociation of HIV Infection and Incident Abdominal Aortic Aneurysm Among 143 001 Veterans
Filipkowski A, Kundu S, Eden S, Alcorn C, Justice A, So-Armah K, Tindle H, Wells Q, Beckman J, Freiberg M, Aday A. Association of HIV Infection and Incident Abdominal Aortic Aneurysm Among 143 001 Veterans. Circulation 2023, 148: 135-143. PMID: 37226738, PMCID: PMC10443901, DOI: 10.1161/circulationaha.122.063040.Peer-Reviewed Original ResearchConceptsIncident abdominal aortic aneurysmT-cell countsHIV viral loadAbdominal aortic aneurysmRisk of AAAHIV infectionViral loadAortic aneurysmElevated HIV viral loadCardiovascular disease risk factorsVeterans Aging Cohort StudyCox proportional hazards modelCurrent Procedural Terminology codesAging Cohort StudyDisease risk factorsProportional hazards modelProcedural Terminology codesPrevious cross-sectional dataAAA eventsLow CD4Cohort studyHIV statusRisk factorsLongitudinal cohortCardiovascular diseaseMulti-trait genome-wide association analyses leveraging alcohol use disorder findings identify novel loci for smoking behaviors in the Million Veteran Program
Cheng Y, Dao C, Zhou H, Li B, Kember R, Toikumo S, Zhao H, Gelernter J, Kranzler H, Justice A, Xu K. Multi-trait genome-wide association analyses leveraging alcohol use disorder findings identify novel loci for smoking behaviors in the Million Veteran Program. Translational Psychiatry 2023, 13: 148. PMID: 37147289, PMCID: PMC10162964, DOI: 10.1038/s41398-023-02409-2.Peer-Reviewed Original ResearchConceptsSingle-trait genome-wide association studiesGenome-wide association studiesNovel lociPower of GWASJoint genome-wide association studyGenome-wide significant lociMillion Veteran ProgramGenome-wide associationSubstance use traitsGWAS summary statisticsNovel genetic variantsMulti-trait analysisFunctional annotationUse traitsSignificant lociHeritable traitMultiple lociAssociation studiesColocalization analysisLociPleiotropic effectsMTAgVeteran ProgramGenetic variantsTraitsRacial and Ethnic Bias in the Diagnosis of Alcohol Use Disorder in Veterans
Vickers-Smith R, Justice A, Becker W, Rentsch C, Curtis B, Fernander A, Hartwell E, Ighodaro E, Kember R, Tate J, Kranzler H. Racial and Ethnic Bias in the Diagnosis of Alcohol Use Disorder in Veterans. American Journal Of Psychiatry 2023, 180: 426-436. PMID: 37132202, PMCID: PMC10238581, DOI: 10.1176/appi.ajp.21111097.Peer-Reviewed Original ResearchConceptsAlcohol use disorderAlcohol consumptionAUD diagnosisHispanic veteransWhite veteransUse disordersPrevalence of AUDAlcohol Use Disorders Identification TestUnhealthy alcohol useICD-10 codesAUDIT-C scoresSelf-reported alcohol consumptionAlcohol-related disordersDiagnosis of AUDDisorders Identification TestMaximum scoreSelf-reported raceElectronic health recordsPrimary outcomeAlcohol consumption levelsPotential confoundersHigh prevalenceMillion Veteran ProgramGreater oddsICD-9
2022
Potentially inappropriate medication use by level of polypharmacy among US Veterans 49–64 and 65–70 years old
Guillot J, Rentsch CT, Gordon KS, Justice AC, Bezin J. Potentially inappropriate medication use by level of polypharmacy among US Veterans 49–64 and 65–70 years old. Pharmacoepidemiology And Drug Safety 2022, 31: 1056-1074. PMID: 35780391, PMCID: PMC9464694, DOI: 10.1002/pds.5506.Peer-Reviewed Original ResearchConceptsLevel of polypharmacyRace/ethnicityPIM prevalencePrevalence of PIMsInappropriate medication useElectronic health recordsCommon PIMsPharmacy fillsPROMPT criteriaInappropriate medicationsOlder patientsMedication usePsychotropic medicationsRefill recordsPolypharmacyPatientsVeterans AffairsMedicationsPrevalenceHealth recordsFiscal year 2016AgeMeaningful differencesSexTarget agePatient-Reported Bothersome Symptoms Attributed to Alcohol Use Among People With and Without HIV
Gordon KS, Becker WC, Bryant KJ, Crystal S, Maisto SA, Marshall BDL, McInnes DK, Satre DD, Williams EC, Edelman EJ, Justice AC. Patient-Reported Bothersome Symptoms Attributed to Alcohol Use Among People With and Without HIV. AIDS And Behavior 2022, 26: 3589-3596. PMID: 35553287, PMCID: PMC10084471, DOI: 10.1007/s10461-022-03628-2.Peer-Reviewed Original ResearchMeSH KeywordsAlcohol DrinkingCohort StudiesHIV InfectionsHumansPatient Reported Outcome MeasuresVeteransPeriods 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
HIV care using differentiated service delivery during the COVID‐19 pandemic: a nationwide cohort study in the US Department of Veterans Affairs
McGinnis KA, Skanderson M, Justice AC, Akgün KM, Tate JP, King JT, Rentsch CT, Marconi VC, Hsieh E, Ruser C, Kidwai‐Khan F, Yousefzadeh R, Erdos J, Park LS. HIV care using differentiated service delivery during the COVID‐19 pandemic: a nationwide cohort study in the US Department of Veterans Affairs. Journal Of The International AIDS Society 2021, 24: e25810. PMID: 34713585, PMCID: PMC8554215, DOI: 10.1002/jia2.25810.Peer-Reviewed Original ResearchMeSH KeywordsCohort StudiesCOVID-19FemaleHIV InfectionsHumansMalePandemicsSARS-CoV-2United StatesVeteransConceptsVeterans AffairsClinic visitsCohort studyVL testARV coverageCOVID-19 pandemicVeterans Aging Cohort StudyHIV healthcare deliveryNationwide cohort studyAging Cohort StudyViral load testsDifferentiated service deliveryHealthcare deliveryHIV careMost patientsPharmacy recordsVL testingCalendar periodHealthcare encountersOverall healthARVVirtual healthcareVirtual visitsVisitsService deliveryDiscrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America
McGinnis KA, Justice AC, Moore RD, Silverberg MJ, Althoff KN, Karris M, Lima VD, Crane HM, Horberg MA, Klein MB, Gange SJ, Gebo KA, Mayor A, Tate JP, Benson C, Bosch R, Kirk G, Marconi V, Colasanti J, Mayer K, Grasso C, Hogg R, Lima V, Montaner J, Sereda P, Salters K, Buchacz K, Li J, Gebo K, Moore R, Moore R, Jacobson J, Horberg M, Silverberg M, Thorne J, Brown T, Tien P, D’Souza G, Smith G, Loutfy M, Gupta M, Klein M, Rabkin C, Kroch A, Burchell A, Betts A, Lindsay J, Nijhawan A, Mayor A, Gill M, Martin J, Li J, Brooks J, Saag M, Mugavero M, Willig J, Bamford L, Karris M, Eron J, Napravnik S, Kitahata M, Crane H, Sterling T, Haas D, Rebeiro P, Turner M, McGinnis K, Justice A, Moore R, Althoff K, Gange S, Kitahata M, Lee J, Saag M, Horberg M, Klein M, McKaig R, Freeman A, Moore R, Althoff K, Freeman A, Kitahata M, Van Rompaey S, Crane H, Morton L, McReynolds J, Lober W, Gange S, Lee J, Hogan B, You B, Humes E, Gerace L, Stewart C, Coburn S. Discrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America. Clinical Infectious Diseases 2021, 75: 297-304. PMID: 34609485, PMCID: PMC9410720, DOI: 10.1093/cid/ciab883.Peer-Reviewed Original ResearchConceptsNorth American AIDS Cohort CollaborationVACS Index 2.0National Death IndexHIV-1 RNAHuman immunodeficiency virusCopies/mLRisk of mortalityRace/ethnicityCohort CollaborationNA-ACCORDCause mortalityCD4 countMedian ageDeath IndexImmunodeficiency virusPredicting MortalityMortality ascertainmentMortality rateMortalitySpecific biomarkersPWHDiverse cohortObserved mortalityCohortHIVBrief 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 reportsHIVAccuracy of the Veterans Health Administration COVID-19 (VACO) Index for predicting short-term mortality among 1307 US academic medical centre inpatients and 427 224 US Medicare patients
King JT, Yoon JS, Bredl ZM, Habboushe JP, Walker GA, Rentsch CT, Tate JP, Kashyap NM, Hintz RC, Chopra AP, Justice AC. Accuracy of the Veterans Health Administration COVID-19 (VACO) Index for predicting short-term mortality among 1307 US academic medical centre inpatients and 427 224 US Medicare patients. Journal Of Epidemiology & Community Health 2021, 76: 254-260. PMID: 34583962, PMCID: PMC8483922, DOI: 10.1136/jech-2021-216697.Peer-Reviewed Original ResearchConceptsVACO IndexShort-term mortalityAcademic medical centerCause mortalityMedicare inpatientMedical CenterSingle US academic medical centerCOVID-19 indexTime of diagnosisUS academic medical centersUS Medicare patientsGreater clinical attentionCOVID-19SARS-CoV-2Nationwide cohortComorbidity diagnosesMedicare cohortInpatient populationUS veteransMedicare patientsHospital dataMedicare dataOutpatient dataClinical attentionInpatientsHIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
Freiberg MS, Duncan MS, Alcorn C, Chang C, Kundu S, Mumpuni A, Smith EK, Loch S, Bedigian A, Vittinghoff E, So‐Armah K, Hsue PY, Justice AC, Tseng ZH. HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death. Journal Of The American Heart Association 2021, 10: e021268. PMID: 34493058, PMCID: PMC8649505, DOI: 10.1161/jaha.121.021268.Peer-Reviewed Original ResearchConceptsHIV viral loadCD4 cell countFirst clinical visitHIV infectionViral loadSCD riskCell countWorld Health OrganizationCopies/Elevated HIV viral loadLow CD4 cell countsSudden cardiac death rateVeterans Aging Cohort StudyCox proportional hazards regressionHealth OrganizationConclusions HIV infectionSCD risk factorsCardiac death rateAging Cohort StudyProportional hazards regressionSudden cardiac deathCells/Mean baseline ageRace/ethnicityCohort studyCD4+ 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 ResearchMeSH KeywordsCD4 Lymphocyte CountCohort StudiesHIV InfectionsHumansIntensive Care UnitsSurvivorsVeteransPharmacoepidemiology, Machine Learning, and COVID-19: An Intent-to-Treat Analysis of Hydroxychloroquine, With or Without Azithromycin, and COVID-19 Outcomes Among Hospitalized US Veterans
Gerlovin H, Posner DC, Ho YL, Rentsch CT, Tate JP, King JT, Kurgansky KE, Danciu I, Costa L, Linares FA, Goethert ID, Jacobson DA, Freiberg MS, Begoli E, Muralidhar S, Ramoni RB, Tourassi G, Gaziano JM, Justice AC, Gagnon DR, Cho K. Pharmacoepidemiology, Machine Learning, and COVID-19: An Intent-to-Treat Analysis of Hydroxychloroquine, With or Without Azithromycin, and COVID-19 Outcomes Among Hospitalized US Veterans. American Journal Of Epidemiology 2021, 190: 2405-2419. PMID: 34165150, PMCID: PMC8384407, DOI: 10.1093/aje/kwab183.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAnti-Bacterial AgentsAzithromycinCOVID-19COVID-19 Drug TreatmentDrug Therapy, CombinationFemaleHospitalizationHumansHydroxychloroquineIntention to Treat AnalysisMachine LearningMaleMiddle AgedPharmacoepidemiologyRetrospective StudiesSARS-CoV-2Treatment OutcomeUnited StatesVeteransConceptsUS veteransCOVID-19Veterans Affairs Health Care SystemRecent randomized clinical trialsAdministration of hydroxychloroquineEffectiveness of hydroxychloroquineRisk of intubationEffect of hydroxychloroquineElectronic health record dataRandomized clinical trialsTreatment of patientsUS veteran populationCOVID-19 outcomesCoronavirus disease 2019Health record dataRigorous study designsHealth care systemSurvival benefitTreat analysisEarly therapyHospitalized populationClinical trialsObservational studyDisease 2019HydroxychloroquineAssociation between HIV and incident pulmonary hypertension in US Veterans: a retrospective cohort study
Duncan MS, Alcorn CW, Freiberg MS, So-Armah K, Patterson OV, DuVall SL, Crothers KA, Re VL, Butt AA, Lim JK, Kim JW, Tindle HA, Justice AC, Brittain EL. Association between HIV and incident pulmonary hypertension in US Veterans: a retrospective cohort study. The Lancet Healthy Longevity 2021, 2: e417-e425. PMID: 34296203, PMCID: PMC8294078, DOI: 10.1016/s2666-7568(21)00116-1.Peer-Reviewed Original ResearchConceptsIncident pulmonary hypertensionHIV viral loadPulmonary artery systolic pressureVeterans Aging Cohort StudyPulmonary hypertension riskPulmonary hypertensionRetrospective cohort studyCohort studyViral loadIncidence rateHypertension incidenceCD4 countHazard ratioHIV statusSystolic pressureHypertension riskHigh riskLow CD4 cell countsHepatitis C virus infectionHigher HIV viral loadChronic obstructive pulmonary diseaseCox proportional hazards regressionC virus infectionCD4 cell countPrevalent heart failureAssociation of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection
Chichetto NE, Kundu S, Freiberg MS, Koethe JR, Butt AA, Crystal S, So-Armah KA, Cook RL, Braithwaite RS, Justice AC, Fiellin DA, Khan M, Bryant KJ, Gaither JR, Barve SS, Crothers K, Bedimo RJ, Warner A, Tindle HA. Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection. AIDS And Behavior 2021, 25: 2852-2862. PMID: 34101074, PMCID: PMC8376776, DOI: 10.1007/s10461-021-03327-4.Peer-Reviewed Original ResearchConceptsIncident cardiovascular diseaseUnhealthy alcohol useCardiovascular diseaseDepressive symptomsCVD riskHIV statusAlcohol useMultivariable Cox proportional hazards regressionCases of CVDCox proportional hazards regressionCVD-free participantsHIV-negative veteransProportional hazards regressionHIV-negativeHIV infectionHazards regressionSyndemic conditionsExcess riskRisk factorsDiagnostic codesHigh prevalenceObservational studyBaseline numberGreater riskSmoking
2020
Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV
Zifodya JS, Duncan MS, So‐Armah K, Attia EF, Akgün KM, Rodriguez‐Barradas M, Marconi VC, Budoff MJ, Bedimo RJ, Alcorn CW, Hoo G, Butt AA, Kim JW, Sico JJ, Tindle HA, Huang L, Tate JP, Justice AC, Freiberg MS, Crothers K. Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV. Journal Of The American Heart Association 2020, 9: e017645. PMID: 33222591, PMCID: PMC7763776, DOI: 10.1161/jaha.120.017645.Peer-Reviewed Original ResearchConceptsCommunity-acquired pneumoniaCVD risk factorsCVD eventsRisk factorsCAP severityHIV infectionHIV statusSevere community-acquired pneumoniaVeterans Aging Cohort StudyIncident CVD eventsCardiovascular disease eventsMultivariable-adjusted modelsAging Cohort StudyCox regression analysisDate of admissionMultivariable-adjusted analysesHigher mortality riskBackground HospitalizationCAP hospitalizationsHIV-uninfectedCardiovascular eventsIncident CVDCohort studyCVD riskUS veteransDNA 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 associationHIVDoes Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms?
Caniglia EC, Stevens ER, Khan M, Young KE, Ban K, Marshall BDL, Chichetto NE, Gaither JR, Crystal S, Edelman EJ, Fiellin DA, Gordon AJ, Bryant KJ, Tate J, Justice AC, Braithwaite RS. Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms? Alcohol Clinical And Experimental Research 2020, 44: 2257-2265. PMID: 33030753, PMCID: PMC8077101, DOI: 10.1111/acer.14455.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol usePain interferenceTobacco smokingUS veteransOdds ratioPsychiatric symptomsDepressive symptomsCocaine useVeterans Aging Cohort StudyAlcohol Use Disorders Identification Test (AUDIT) questionnaireCannabis useSubstance useAging Cohort StudyAnxiety symptomsSeparate logistic regression modelsChronic pain interferenceMultisite observational studyLogistic regression modelsCohort studyInverse probability weightingNext followObservational studyPotential selection biasYears postbaseline