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 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 periodCohortMortalityDrugsIndexBiomarkersSeverity
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 testsIndexDeliriumHospitalizationPneumoniaHIVInfectionImproved discrimination of mortality with Veterans Aging Cohort Study (VACS) Index 2.0 in HIV-positive individuals
Tate JP, Sterne JAC, Justice AC. Improved discrimination of mortality with Veterans Aging Cohort Study (VACS) Index 2.0 in HIV-positive individuals. AIDS 2019, Publish Ahead of Print: &na;. PMID: 30649058, PMCID: PMC6749990, DOI: 10.1097/qad.0000000000002140.Peer-Reviewed Original ResearchConceptsWhite blood countC-statisticBlood countVeterans Aging Cohort Study (VACS) IndexAntiretroviral Therapy Cohort CollaborationDiscrimination of mortalityVACS Index 2.0Antiretroviral therapy initiationCD4 cell countHIV-positive populationHarrell's C-statisticHIV-1 RNAHIV-positive individualsKaplan-Meier plotsCohort CollaborationNadir CD4VAC patientsAntiretroviral therapyCause mortalityCD8 ratioTherapy initiationViral suppressionGeneral healthExcess mortalityLaboratory values
2018
Markers 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 score
2014
The VACS Index Predicts Mortality in a Young, Healthy HIV Population Starting Highly Active Antiretroviral Therapy
Bebu I, Tate J, Rimland D, Mesner O, Macalino GE, Ganesan A, Okulicz JF, Bavaro M, Weintrob AC, Justice AC, Agan BK. The VACS Index Predicts Mortality in a Young, Healthy HIV Population Starting Highly Active Antiretroviral Therapy. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2014, 65: 226-230. PMID: 24226058, PMCID: PMC4091811, DOI: 10.1097/qai.0000000000000045.Peer-Reviewed Original ResearchConceptsVACS IndexActive antiretroviral therapyCause mortalityAntiretroviral therapyHIV populationVeterans Aging Cohort Study (VACS) IndexActive antiretroviral therapy (HAART) initiationAntiretroviral therapy initiationPrediction of mortalityGood discriminationNHS subjectsTherapy initiationDifferent time pointsStudy cohortSimilar patientsClinical variablesEarly risk assessmentMedical historyVAC indexHealthy populationMortalityStudy indicesOutcome predictionTime pointsLaboratory data
2013
Association of the Veterans Aging Cohort Study Index with Exercise Capacity in HIV-Infected Adults
Oursler KK, Tate JP, Gill TM, Crothers K, Brown TT, Crystal S, Womack J, Leaf DA, Sorkin JD, Justice AC. Association of the Veterans Aging Cohort Study Index with Exercise Capacity in HIV-Infected Adults. AIDS Research And Human Retroviruses 2013, 29: 1218-1223. PMID: 23705911, PMCID: PMC3749694, DOI: 10.1089/aid.2012.0388.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort Study (VACS) IndexVACS IndexHigh riskLeg strengthMedian CD4 cell countStudy indicesMuscle cross-sectional areaPhysical disabilityVACS Index scoreCD4 cell countClinical risk factorsClinical laboratory valuesIdentification of patientsClinical blood testsRoutine clinical blood testsLower extremity strengthGreater mortality riskLower leg strengthQuality of lifeMiddle-aged adultsAfrican American menExercise capacityWalk distanceHIV infectionQuadriceps strengthMedical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*
Akgün KM, Tate JP, Pisani M, Fried T, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Medical ICU Admission Diagnoses and Outcomes in Human Immunodeficiency Virus–Infected and Virus–Uninfected Veterans in the Combination Antiretroviral Era*. Critical Care Medicine 2013, 41: 1458-1467. PMID: 23507717, PMCID: PMC4283206, DOI: 10.1097/ccm.0b013e31827caa46.Peer-Reviewed Original ResearchConceptsMedical ICU admissionVeterans Aging Cohort Study (VACS) IndexICU admissionAntiretroviral therapyRespiratory diagnosesMechanical ventilationVeterans Aging Cohort Study Index scoresUndetectable HIV-1 RNALogistic regressionStudy indicesVeterans Affairs Medical CenterCombination antiretroviral eraCritical care requirementsICU admission diagnosisMedical ICU careCombination antiretroviral therapyInfection/sepsisHIV-1 RNAHuman immunodeficiency virusMultivariable logistic regressionRoutine clinical biomarkersHigh mortality rateRevenue center codesAdmission diagnosisICU mortalityPhysiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans
Womack JA, Goulet JL, Gibert C, Brandt CA, Skanderson M, Gulanski B, Rimland D, Rodriguez-Barradas MC, Tate J, Yin MT, Justice AC, Team F. Physiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans. Clinical Infectious Diseases 2013, 56: 1498-1504. PMID: 23378285, PMCID: PMC3634308, DOI: 10.1093/cid/cit056.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusVACS Index scoreFragility fracturesPhysiologic frailtyVACS IndexMale veteransInhibitor useFracture riskRisk factorsVeterans Aging Cohort Study (VACS) IndexIndex scoreFragility fracture risk factorsICD-9-CM codesProtease inhibitor useFracture risk factorsMarkers of inflammationBody mass indexUpper arm fracturesAlcohol-related diagnosesCox regression modelFirst fragility fractureCause mortalityHIV RNAHemoglobin levelsMass indexPredictive Accuracy of the Veterans Aging Cohort Study Index for Mortality With HIV Infection
Justice AC, Modur SP, Tate JP, Althoff KN, Jacobson LP, Gebo KA, Kitahata MM, Horberg MA, Brooks JT, Buchacz K, Rourke SB, Rachlis A, Napravnik S, Eron J, Willig JH, Moore R, Kirk GD, Bosch R, Rodriguez B, Hogg RS, Thorne J, Goedert JJ, Klein M, Gill J, Deeks S, Sterling TR, Anastos K, Gange SJ. Predictive Accuracy of the Veterans Aging Cohort Study Index for Mortality With HIV Infection. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2013, 62: 149-163. PMID: 23187941, PMCID: PMC3619393, DOI: 10.1097/qai.0b013e31827df36c.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAlanine TransaminaseAnti-Retroviral AgentsAspartate AminotransferasesBiomarkersCD4 Lymphocyte CountCohort StudiesCreatinineFemaleHemoglobinsHepatitis CHIV InfectionsHIV-1HumansKaplan-Meier EstimateMaleMiddle AgedNorth AmericaPlatelet CountPredictive Value of TestsRisk AssessmentRNA, ViralSex FactorsConceptsNet reclassification improvementVeterans Aging Cohort Study (VACS) IndexVeterans Affairs Healthcare SystemAntiretroviral therapyPatient subgroupsNorth American AIDS Cohort CollaborationHIV-1 RNA levelsStudy indicesObserved mortalityPrior ART exposureVACS Index scoreHIV-1 RNAImportant patient subgroupsRisk of mortalityHealthcare systemDiverse patient subgroupsCohort CollaborationHIV biomarkersVACS IndexHIV infectionOrgan injuryParametric survival modelsART exposureReclassification improvementC-statistic
2012
Does an Index Composed of Clinical Data Reflect Effects of Inflammation, Coagulation, and Monocyte Activation on Mortality Among Those Aging With HIV?
Justice AC, Freiberg MS, Tracy R, Kuller L, Tate JP, Goetz MB, Fiellin DA, Vanasse GJ, Butt AA, Rodriguez-Barradas MC, Gibert C, Oursler KA, Deeks SG, Bryant K, Team T. Does an Index Composed of Clinical Data Reflect Effects of Inflammation, Coagulation, and Monocyte Activation on Mortality Among Those Aging With HIV? Clinical Infectious Diseases 2012, 54: 984-994. PMID: 22337823, PMCID: PMC3297653, DOI: 10.1093/cid/cir989.Peer-Reviewed Original ResearchConceptsHIV-1 RNANet reclassification improvementHepatitis C virusD-dimerIL-6VACS IndexMonocyte activationVeterans Aging Cohort Study (VACS) IndexHuman immunodeficiency virus type 1 (HIV-1) RNAFIB-4 indexGlomerular filtration rateMarkers of liverRoutine clinical variablesCopies/mLPrediction of mortalityEffects of inflammationHCV statusAntiretroviral therapyCD4 countRenal injuryReclassification improvementClinical variablesC-statisticC virusFiltration rate