Evidence map›Paper›PMID 26070969›Full record

ArticleThe Lancet. Infectious diseases2015

Future challenges for clinical care of an ageing population infected with HIV: a modelling study.

Mikaela Smit, Kees Brinkman, Suzanne Geerlings, Colette Smit, Kalyani Thyagarajan, Ard van Sighem, Frank de Wolf, Timothy B Hallett, ATHENA observational cohort

Erratum issued Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Infectious diseases, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06784154 (The Association of Ectopic Fat and Cardiovascular Disease in People Living With HIV and General Populations), which is not on this map. Cited by 497 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
497citing papers in PubMed, 11 pooled it
54.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06784154 recruitingnot on this mapstarted 2024, after this paper: background citation

The Association of Ectopic Fat and Cardiovascular Disease in People Living With HIV and General Populations: A Cross Sectional Analysis

TypeobservationalSponsorUniversity of LiverpoolRan2024 to 2027Enrolled100ConditionsCardiometabolic Syndrome, HivArmsNon-interventional
3 · Its place in the literature

Who cites it

497 citing papers in PubMed, 11 syntheses or guidelines pooled it, 907 citations in OpenAlex.

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  20. Impact of Integrase Inhibitors on Cardiovascular Disease Events in People With Human Immunodeficiency Virus Starting Antiretroviral Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
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437 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Mikaela SmitDepartment of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK. Electronic address: mikaela.smit@imperial.ac.uk.
Kees BrinkmanDepartment of Internal Medicine, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands.
Suzanne GeerlingsDivision of Infectious Diseases, Amsterdam Medical Centre, Amsterdam, Netherlands.
Colette SmitStichting HIV Monitoring, Amsterdam, Netherlands.
Kalyani Thyagarajanindependent consultant, London, UK.
Ard van SighemStichting HIV Monitoring, Amsterdam, Netherlands.
Frank de WolfDepartment of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
Timothy B HallettDepartment of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College London, London, UK.
ATHENA observational cohort
Imperial College London · GBStichting HIV Monitoring · NLAcademic Medical Center · NLOLVG · NL

Funding

Medical Research Council MR/K010174/1
6 · The paper itself

Abstract

backgroundThe population infected with HIV is getting older and these people will increasingly develop age-related non-communicable diseases (NCDs). We aimed to quantify the scale of the change and the implications for HIV care in the Netherlands in the future.

methodsWe constructed an individual-based model of the ageing HIV-infected population, which followed patients on HIV treatment as they age, develop NCDs-including cardiovascular disease (hypertension, hypercholesterolaemia, myocardial infarctions, and strokes), diabetes, chronic kidney disease, osteoporosis, and non-AIDS malignancies-and start co-medication for these diseases. The model was parameterised by use of data for 10 278 patients from the national Dutch ATHENA cohort between 1996 and 2010. We made projections up to 2030.

findingsOur model suggests that the median age of HIV-infected patients on combination antiretroviral therapy (ART) will increase from 43·9 years in 2010 to 56·6 in 2030, with the proportion of HIV-infected patients aged 50 years or older increasing from 28% in 2010 to 73% in 2030. In 2030, we predict that 84% of HIV-infected patients will have at least one NCD, up from 29% in 2010, with 28% of HIV-infected patients in 2030 having three or more NCDs. 54% of HIV-infected patients will be prescribed co-medications in 2030, compared with 13% in 2010, with 20% taking three or more co-medications. Most of this change will be driven by increasing prevalence of cardiovascular disease and associated drugs. Because of contraindications and drug-drug interactions, in 2030, 40% of patients could have complications with the currently recommended first-line HIV regimens.

interpretationThe profile of patients in the Netherlands infected with HIV is changing, with increasing numbers of older patients with multiple morbidities. These changes mean that, in the near future, HIV care will increasingly need to draw on a wide range of medical disciplines, in addition to evidence-based screening and monitoring protocols to ensure continued high-quality care. These findings are based on a large dataset of HIV-infected patients in the Netherlands, but we believe that the overall patterns will be repeated elsewhere in Europe and North America. The implications of such a trend for care of HIV-infected patients in high-burden countries in Africa could present a particular challenge.

fundingMedical Research Council, Bill & Melinda Gates Foundation, Rush Foundation, and Netherlands Ministry of Health, Welfare and Sport.

Indexed as

AgingModels, TheoreticalAdultAge FactorsAnti-Retroviral AgentsCardiovascular DiseasesCohort StudiesComorbidityDiabetes MellitusDrug InteractionsFemaleHealth Services Needs and DemandHIV InfectionsHumansMaleMiddle AgedAnti-Retroviral Agents

Identifiers

PMID26070969
PMCPMC4528076
OpenAlexW2103115327

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.