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- Murphy, K., et al.
(author)
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Association of self-reported race with AIDS death in continuous HAART users in a cohort of HIV-infected women in the United States
- 2013
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In: Aids. - : Ovid Technologies (Wolters Kluwer Health). - 0269-9370. ; 27:15, s. 2413-2423
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Journal article (peer-reviewed)abstract
- Objective:To assess the association of race with clinical outcomes in HIV-positive women on continuous HAART.Design:Prospective study that enrolled women from 1994 to 1995 and 2001 to 2002.Setting:Women's Interagency HIV Study, a community-based cohort in five US cities.Participants:One thousand, four hundred and seventy-one HIV-positive continuous HAART users.Main outcome measures:Times to AIDS and non-AIDS death and incident AIDS-defining illness (ADI) after HAART initiation.Results:In adjusted analyses, black vs. white women had higher rates of AIDS death [adjusted hazard ratio (aHR) 2.14, 95% confidence interval (CI) 1.30, 3.50; P=0.003] and incident ADI (aHR 1.58, 95% CI 1.08, 2.32; P=0.02), but not non-AIDS death (aHR 0.91, 95% CI 0.59, 1.39; P=0.65). Cumulative AIDS death incidence at 10 years was 17.3 and 8.3% for black and white women, respectively. Other significant independent pre-HAART predictors of AIDS death included peak viral load (aHR 1.70 per log(10), 95% CI 1.34, 2.16; P<0.001), nadir CD4(+) cell count (aHR 0.65 per 100cells/l, 95% CI 0.56, 0.76; P<0.001), depressive symptoms by Center for Epidemiology Studies Depression score at least 16 (aHR 2.10, 95% CI 1.51, 2.92; P<0.001), hepatitis C virus infection (aHR 1.57, 95% CI 1.02, 2.40; P=0.04), and HIV acquisition via transfusion (aHR 2.33, 95% CI 1.21, 4.49; P=0.01). In models with time-updated HAART adherence, association of race with AIDS death remained statistically significant (aHR 3.09, 95% CI 1.38, 6.93; P=0.006).Conclusion:In continuous HAART-using women, black women more rapidly died from AIDS or experienced incident ADI than their white counterparts after adjusting for confounders. Future studies examining behavioral and biologic factors in these women may further the understanding of HAART prognosis.
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- Gustafson, Deborah, 1966, et al.
(author)
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Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women's Interagency HIV Study
- 2013
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In: Journal of Neurovirology. - : Springer Science and Business Media LLC. - 1355-0284 .- 1538-2443. ; 19:6, s. 574-585
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Journal article (peer-reviewed)abstract
- This study aimed to explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV-) infection. One thousand six hundred ninety participants (1,196 HIV+, 494 HIV-) in the Women's Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Among HIV+ women, BMI<18.5 kg/m(2) was associated with poorer cognitive performance evidenced by longer Trails A and Trails B and shorter SDMT completion times. An obese BMI (30 kg/m(2) or higher) was related to better performance on Trails B and worse performance on the Stroop interference test. Among HIV-women, an obese BMI was related to worse performance on the Stroop color naming test. Few and inconsistent associations were observed between WC, WHR, and cognition. Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV-infected women.
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