Immunology and Allergy; Dermatology; Public Health, Environmental and Occupational Health; Infectious Diseases
Abstract :
[en] [en] OBJECTIVES: The primary objective of this study was to characterize women living with HIV (WLWH) in Belgium. The secondary objective was an exploratory analysis comparing women and men living with HIV (MLWH).
METHODS: This was a cross-sectional, observational, multicenter study. Inclusion criteria for the primary objective were all adult treatment-naïve and experienced WLWH actively being treated at one of the participating centers. For the secondary objective, inclusion criteria were all adult naïve and experienced women and MLWH, actively being treated at a single participating center. Data were collected between December 2022 and March 2023. A multivariable analysis was performed on all women included to evaluate for associations with having hypertension (HTN) or being virologically nonsuppressed (HIV-1 VL ≥200 copies/mL). In the exploratory analysis of women and MLWH, a multivariable analysis was carried out to evaluate whether female gender was associated with having HTN or being virologically nonsuppressed.
RESULTS: Overall, 2797 WLWH were included. The majority were Black (73.5%) and 48.5% were aged ≥50 years. The most common comorbidity was HTN (17.3%) and most individuals were virologically suppressed (HIV-1 VL <50 copies/mL; 85.6%). Black race was associated with having HTN (p < 0.0001). Prior AIDS-defining illness (p = 0.02) and a CD4+ T-cell count <500 cells/µL (p < 0.0001) were associated with being nonsuppressed. A total of 1094 WLWH and 1878 MLWH were included in the exploratory analysis. HTN was higher among WLWH (20.2% vs. 12% MLWH). Female gender was not found to be associated with having HTN (p = 0.86) or being nonsuppressed (p = 0.14).
CONCLUSION: In this analysis of WLWH in Belgium, the results depict an ageing population that is predominantly Black. The most common comorbidity observed was HTN. Women had a low rate of virologic nonsuppression, and female gender was not associated with being nonsuppressed.
Disciplines :
Immunology & infectious disease
Author, co-author :
Nasreddine, Rakan ; Saint-Pierre University Hospital, Brussels, Belgium
Yombi, Jean Cyr ; Cliniques Universitaires Saint-Luc, Brussels, Belgium
Darcis, Gilles ; Université de Liège - ULiège > Département des sciences de la santé publique
Van Frankenhuijsen, Maartje ; Institute of Tropical Medicine, Antwerp, Belgium
Van Petersen, Lida ; Institute of Tropical Medicine, Antwerp, Belgium
Abels, Chloé; MSD, Watermael-Boitsfort, Belgium
Dos Santos Mendes, Sofia; MSD, Watermael-Boitsfort, Belgium
Delforge, Marc ; Saint-Pierre University Hospital, Brussels, Belgium
De Wit, Stéphane ; Saint-Pierre University Hospital, Brussels, Belgium
Language :
English
Title :
A Characterization of Women Living with HIV in Belgium.
UNAIDS, “Global HIV and AIDS statistics—fact sheet 2022,” 2023, https://www.unaids.org/en/resources/fact-sheet.
M. M. Addo and M. Altfeld, “Sex-based diferences in HIV type 1 pathogenesis,” Journal of Infectious Diseases, vol. 209, no. 3, pp. S86–S92, 2014.
J. S. Mathad, N. Gupte, A. Balagopal et al., “Sex-related diferences in infammatory and immune activation markers before and after combined antiretroviral therapy initiation,” JAIDS Journal of Acquired Immune Defciency Syndromes, vol. 73, no. 2, pp. 123–129, 2016.
M. J. Curno, S. Rossi, I. Hodges-Mameletzis, R. Johnston, M. A. Price, and S. Heidari, “A systematic review of the inclusion (or exclusion) of women in HIV research: from clinical studies of antiretrovirals and vaccines to cure strategies,” JAIDS Journal of Acquired Immune Defciency Syndromes, vol. 71, no. 2, pp. 181–188, 2016.
Sciensano, “Epidémiologie du sida et de l’infection à VIH en Belgique: situation au 31 décembre 2022,” 2023, https://www.sciensano.be/en/biblio/epidemiologie-du-vih-en-belgiquesituation-au-31-decembre-2022.
E. L. Frazier, M. Y. Sutton, Y. Tie, J. Fagan, and R. N. Fanfair, “Diferences by sex in cardiovascular comorbid conditions among older adults (Aged 50–64 or ≥65 Years) receiving care for human immunodefciency virus,” Clinical Infectious Diseases, vol. 69, no. 12, pp. 2091–2100, 2019.
E. L. Bradley, A. M. Williams, S. Green et al., “Disparities in incidence of human immunodefciency virus infection among black and white women — United States, 2010–2016,” Morbidity and Mortality Weekly Report, vol. 68, no. 18, pp. 416–418, 2019.
D. A. Blanas, K. Nichols, M. Bekele, A. Lugg, R. P. Kerani, and C. R. Horowitz, “HIV/AIDS among African-born residents in the United States,” Journal of Immigrant and Minority Health, vol. 15, no. 4, pp. 718–724, 2013.
J. Ross, M. J. Akiyama, D. Slawek et al., “Undocumented African immigrants’ experiences of HIV testing and linkage to care,” AIDS Patient Care and STDs, vol. 33, no. 7, pp. 336–341, 2019.
G. Guaraldi, G. Orlando, S. Zona et al., “Premature age-related comorbidities among HIV-infected persons compared with the general population,” Clinical Infectious Diseases, vol. 53, no. 11, pp. 1120–1126, 2011.
A. Ronit, J. Gerstoft, L. Nielsen et al., “Non-AIDS comorbid conditions in persons living with human immunodefciency virus (HIV) compared with uninfected individuals 10 years before HIV diagnosis,” Clinical Infectious Diseases, vol. 67, no. 8, pp. 1291–1293, 2018.
M. A. Donaldson, A. R. Campbell, A. Y. Albert et al., “Comorbidity and polypharmacy among women living with HIV in British Columbia,” AIDS, vol. 33, no. 15, pp. 2317–2326, 2019.
World Health Organization, “Hypertension Belgium 2023 country profle,” 2024, https://www.who.int/publications/m/item/hypertension-bel-2023-country-profle.
C. I. Hatleberg, L. Ryom, W. El-Sadr et al., “Gender diferences in the use of cardiovascular interventions in HIV-positive persons; the D:A:D study,” Journal of the International AIDS Society, vol. 21, no. 3, Article ID e25083, 2018.
Y. Ostchega, C. D. Fryar, T. Nwankwo, and D. T. Nguyen, “Hypertension prevalence among adults aged 18 and over: United States, 2017-2018,” NCHS Data Brief, vol. 364, pp. 1–8, 2020.
G. Howard, M. Cushman, C. S. Moy et al., “Association of clinical and social factors with excess hypertension risk in Black compared with White US adults,” JAMA, vol. 320, no. 13, pp. 1338–1348, 2018.
E. Quiros-Roldan, E. Rafetti, E. Focà et al., “Incidence of cardiovascular events in HIV-positive patients compared to general population over the last decade: a population-based study from 2000 to 2012,” AIDS Care, vol. 28, no. 12, pp. 1551–1558, 2016.
V. A. Triant, S. Regan, and S. K. Grinspoon, “MACE incidence among HIV and non-HIV-infected patients in a clinical care cohort,” Conference on Retroviruses and Opportunistic Infections (CROI), 2014.
E. Focà, P. Magro, G. Guaraldi et al., “Elderly HIV-positive women: a gender-based analysis from the multicenter Italian “GEPPO” cohort,” PLoS One, vol. 14, no. 10, Article ID e0222225, 2019.
F. Ibrahim, L. Hamzah, R. Jones, D. Nitsch, C. Sabin, and F. A. Post, “Baseline kidney function as predictor of mortality and kidney disease progression in HIV-positive patients,” American Journal of Kidney Diseases, vol. 60, no. 4, pp. 539–547, 2012.
A. Mocroft, L. Ryom, J. Begovac et al., “Deteriorating renal function and clinical outcomes in HIV-positive persons,” AIDS, vol. 28, no. 5, pp. 727–737, 2014.
A. Mocroft, O. Kirk, P. Reiss et al., “Estimated glomerular fltration rate, chronic kidney disease and antiretroviral drug use in HIV positive patients,” AIDS, vol. 24, no. 11, pp. 1667–1678, 2010.
E. A. B. Russell, A. Y. K. Albert, H. C. F. Côté et al., “Rate of dyslipidemia higher among women living with HIV: a comparison of metabolic and cardiovascular health in a cohort to study aging in HIV,” HIV Medicine, vol. 21, no. 7, pp. 418–428, 2020.
M. Floridia, M. Giuliano, L. Palmisano, and S. Vella, “Gender diferences in the treatment of HIV infection,” Pharmacological Research, vol. 58, no. 3–4, pp. 173–182, 2008.
V. Miller, S. Staszewski, C. Sabin et al., “CD4 lymphocyte count as a predictor of the duration of highly active antiretroviral therapy-induced suppression of human immunodefciency virus load,” Te Journal of Infectious Diseases, vol. 180, no. 2, pp. 530–533, 1999.
A. Calcagno, S. Piconi, E. Focà et al., “Role of normalized T-Cell subsets in predicting comorbidities in a large cohort of geriatric HIV-infected patients,” JAIDS Journal of Acquired Immune Defciency Syndromes, vol. 76, no. 3, pp. 338–342, 2017.
P. W. Hunt, S. G. Deeks, B. Rodriguez et al., “Continued CD4 cell count increases in HIV-infected adults experiencing 4 years of viral suppression on antiretroviral therapy,” AIDS, vol. 17, no. 13, pp. 1907–1915, 2003.