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 testsIndexDeliriumHospitalizationPneumoniaHIVInfection
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 mortalityPredictive 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