2023
Association of HIV Infection and Incident Abdominal Aortic Aneurysm Among 143 001 Veterans
Filipkowski A, Kundu S, Eden S, Alcorn C, Justice A, So-Armah K, Tindle H, Wells Q, Beckman J, Freiberg M, Aday A. Association of HIV Infection and Incident Abdominal Aortic Aneurysm Among 143 001 Veterans. Circulation 2023, 148: 135-143. PMID: 37226738, PMCID: PMC10443901, DOI: 10.1161/circulationaha.122.063040.Peer-Reviewed Original ResearchConceptsIncident abdominal aortic aneurysmT-cell countsHIV viral loadAbdominal aortic aneurysmRisk of AAAHIV infectionViral loadAortic aneurysmElevated HIV viral loadCardiovascular disease risk factorsVeterans Aging Cohort StudyCox proportional hazards modelCurrent Procedural Terminology codesAging Cohort StudyDisease risk factorsProportional hazards modelProcedural Terminology codesPrevious cross-sectional dataAAA eventsLow CD4Cohort studyHIV statusRisk factorsLongitudinal cohortCardiovascular disease
2021
Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection
Chichetto NE, Kundu S, Freiberg MS, Koethe JR, Butt AA, Crystal S, So-Armah KA, Cook RL, Braithwaite RS, Justice AC, Fiellin DA, Khan M, Bryant KJ, Gaither JR, Barve SS, Crothers K, Bedimo RJ, Warner A, Tindle HA. Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection. AIDS And Behavior 2021, 25: 2852-2862. PMID: 34101074, PMCID: PMC8376776, DOI: 10.1007/s10461-021-03327-4.Peer-Reviewed Original ResearchConceptsIncident cardiovascular diseaseUnhealthy alcohol useCardiovascular diseaseDepressive symptomsCVD riskHIV statusAlcohol useMultivariable Cox proportional hazards regressionCases of CVDCox proportional hazards regressionCVD-free participantsHIV-negative veteransProportional hazards regressionHIV-negativeHIV infectionHazards regressionSyndemic conditionsExcess riskRisk factorsDiagnostic codesHigh prevalenceObservational studyBaseline numberGreater riskSmoking
2020
Estimating Aspirin Overuse for Primary Prevention of Atherosclerotic Cardiovascular Disease (from a Nationwide Healthcare System)
Ong SY, Chui P, Bhargava A, Justice A, Hauser RG. Estimating Aspirin Overuse for Primary Prevention of Atherosclerotic Cardiovascular Disease (from a Nationwide Healthcare System). The American Journal Of Cardiology 2020, 137: 25-30. PMID: 32991852, DOI: 10.1016/j.amjcard.2020.09.042.Peer-Reviewed Original ResearchConceptsLow-dose aspirinElectronic health recordsSelf-reported useEHR dataPatients' self-reported useLow-dose aspirin useAtherosclerotic cardiovascular diseaseAmerican Heart AssociationEHR recordsNon-specific terminologyAspirin usePrimary preventionHeart AssociationCardiovascular diseaseAmerican CollegeAspirinPatientsHealth recordsEHR implementationEHR searchesImplementable guidelinesGuidelinesRecordsDiseaseCardiology
2019
Comparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people
Torgersen J, So-Armah K, Freiberg MS, Goetz MB, Budoff MJ, Lim JK, Taddei T, Butt AA, Rodriguez-Barradas MC, Justice AC, Kostman JR, Lo Re V. Comparison of the prevalence, severity, and risk factors for hepatic steatosis in HIV-infected and uninfected people. BMC Gastroenterology 2019, 19: 52. PMID: 30987601, PMCID: PMC6466708, DOI: 10.1186/s12876-019-0969-1.Peer-Reviewed Original ResearchConceptsAdvanced hepatic fibrosisSeverity of steatosisHepatic steatosisHIV infectionHIV statusHepatic fibrosisLiver attenuationCardiovascular diseaseSteatosis severityUninfected individualsGreater severityVeterans Aging Cohort StudyNoncontrast abdominal CTAging Cohort StudySpleen attenuation ratioHepatic steatosis severityCross-sectional studyMultivariable linear regressionUninfected participantsAntiretroviral therapyCohort studyAbdominal CTUninfected personsOverall prevalenceRisk factors
2018
Bilirubin Is Inversely Associated With Cardiovascular Disease Among HIV‐Positive and HIV‐Negative Individuals in VACS (Veterans Aging Cohort Study)
Marconi VC, Duncan MS, So‐Armah K, Re VL, Lim JK, Butt AA, Goetz MB, Rodriguez‐Barradas M, Alcorn CW, Lennox J, Beckman JA, Justice A, Freiberg M. Bilirubin Is Inversely Associated With Cardiovascular Disease Among HIV‐Positive and HIV‐Negative Individuals in VACS (Veterans Aging Cohort Study). Journal Of The American Heart Association 2018, 7: e007792. PMID: 29720501, PMCID: PMC6015337, DOI: 10.1161/jaha.117.007792.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionTotal cardiovascular diseaseIschemic stroke eventsCardiovascular diseaseCVD eventsHeart failureMyocardial infarctionTotal bilirubinElevated bilirubinStroke eventsRisk factorsIncident total CVDBaseline total bilirubinBaseline cardiovascular diseaseIncident CVD eventsHIV-negative individualsProspective cohort studyElevated bilirubin levelsMultiple risk factorsCohort studyCVD riskHazard ratioIschemic strokeHIV-positiveBilirubin levels
2017
Can Biomarkers Advance HIV Research and Care in the Antiretroviral Therapy Era?
Justice AC, Erlandson KM, Hunt P, Landay A, Miotti P, Tracy RP. Can Biomarkers Advance HIV Research and Care in the Antiretroviral Therapy Era? The Journal Of Infectious Diseases 2017, 217: 521-528. PMID: 29165684, PMCID: PMC5853399, DOI: 10.1093/infdis/jix586.Peer-Reviewed Original ResearchConceptsHIV infectionLong-term treatment toxicityAntiretroviral therapy eraChronic HIV infectionLow-level inflammationT-cell countsForms of cancerART initiationTherapy eraTreatment toxicityImmune dysfunctionRenal diseaseLiver diseaseChronic inflammationIntervention trialsClinical managementNeurocognitive declineCardiovascular diseaseClinical trialistsUninfected individualsRNA suppressionHIV researchWeight gainTranslational scientistsBiomarkersIncreased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General Population
Drozd DR, Kitahata MM, Althoff KN, Zhang J, Gange SJ, Napravnik S, Burkholder GA, Mathews WC, Silverberg MJ, Sterling TR, Heckbert SR, Budoff MJ, Van Rompaey S, Delaney JAC, Wong C, Tong W, Palella FJ, Elion RA, Martin JN, Brooks JT, Jacobson LP, Eron JJ, Justice AC, Freiberg MS, Klein DB, Post WS, Saag MS, Moore RD, Crane HM. Increased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General Population. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2017, 75: 568-576. PMID: 28520615, PMCID: PMC5522001, DOI: 10.1097/qai.0000000000001450.Peer-Reviewed Original ResearchConceptsTraditional CVD risk factorsDetectable HIV RNACVD risk factorsIncidence rateRisk factorsCD4 countHIV RNAMyocardial infarctionCardiovascular diseaseNorth American AIDS Cohort CollaborationType 1 myocardial infarctionHIV-specific factorsLow CD4 countSuppressive antiretroviral treatmentIncidence rate ratiosCohort CollaborationIncident MINA-ACCORDAggressive managementAntiretroviral treatmentMultivariable analysisAtherosclerosis RiskMI riskCommunity cohortGeneral population
2016
Association Between Depressive Disorders and Incident Acute Myocardial Infarction in Human Immunodeficiency Virus–Infected Adults: Veterans Aging Cohort Study
Khambaty T, Stewart JC, Gupta SK, Chang CH, Bedimo RJ, Budoff MJ, Butt AA, Crane H, Gibert CL, Leaf DA, Rimland D, Tindle HA, So-Armah KA, Justice AC, Freiberg MS. Association Between Depressive Disorders and Incident Acute Myocardial Infarction in Human Immunodeficiency Virus–Infected Adults: Veterans Aging Cohort Study. JAMA Cardiology 2016, 1: 929-937. PMID: 27557332, PMCID: PMC5621480, DOI: 10.1001/jamacardio.2016.2716.Peer-Reviewed Original ResearchConceptsIncident acute myocardial infarctionAcute myocardial infarctionVeterans Aging Cohort StudyAging Cohort StudyCardiovascular diseaseCohort studyDepressive disorderDysthymic disorderMyocardial infarctionRisk factorsHuman immunodeficiency virus-infected adultsIncident atherosclerotic cardiovascular diseaseHIV-specific factorsCVD risk factorsEffective antiretroviral therapyFuture cardiovascular diseaseAtherosclerotic cardiovascular diseaseHuman immunodeficiency virusNovel risk factorsMajor depressive disorderPrimary prevention approachAntiretroviral therapyCVD eventsHepatitis CAntidepressant use
2015
HIV status and the risk of ischemic stroke among men
Sico J, Chang C, So-Armah K, Justice A, Hylek E, Skanderson M, McGinnis K, Kuller L, Kraemer K, Rimland D, Bidwell Goetz M, Butt A, Rodriguez-Barradas M, Gibert C, Leaf D, Brown S, Samet J, Kazis L, Bryant K, Freiberg M, Chang C, So-Armah K, Justice A, Hylek E, Skanderson M, McGinnis K, Kuller L, Kraemer K, Rimland D, Goetz M, Butt A, Rodriguez Barradas M, Gibert C, Leaf D, Brown S, Samet J, Kazis L, Bryant K, Freiberg M. HIV status and the risk of ischemic stroke among men. Neurology 2015, 84: 1933-1940. PMID: 25862803, PMCID: PMC4433456, DOI: 10.1212/wnl.0000000000001560.Peer-Reviewed Original ResearchConceptsIschemic stroke riskVeterans Aging Cohort Study Virtual CohortIschemic stroke risk factorsStroke risk factorsHIV infectionUninfected veteransIschemic strokeStroke riskMale veteransComorbid diseasesRisk factorsSubstance useBaseline cardiovascular diseaseIschemic stroke rateRace/ethnicityHIV biomarkersMedian followStroke eventsHIV statusCardiovascular diseaseStroke rateClinical sitesHIVInfectionStrokeSmoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America
Helleberg M, May MT, Ingle SM, Dabis F, Reiss P, Fätkenheuer G, Costagliola D, d’Arminio A, Cavassini M, Smith C, Justice AC, Gill J, Sterne JA, Obel N. Smoking and life expectancy among HIV-infected individuals on antiretroviral therapy in Europe and North America. AIDS 2015, 29: 221-229. PMID: 25426809, PMCID: PMC4284008, DOI: 10.1097/qad.0000000000000540.Peer-Reviewed Original ResearchConceptsMortality rate ratiosCardiovascular diseaseLife expectancyBackground populationNon-AIDS malignanciesAntiretroviral therapy initiationProportion of smokersNorth American cohortSmoking-related mortalityCause of deathMore life yearsAIDS malignanciesAntiretroviral therapyPrevious smokersTherapy initiationSmoking cessationSmoking increasesExcess mortalityAge 35HIVSmokersAmerican cohortSmokingLife yearsHigh mortality
2014
HIV Infection and Cardiovascular Disease in Women
Womack JA, Chang C, So‐Armah K, Alcorn C, Baker JV, Brown ST, Budoff M, Butt AA, Gibert C, Goetz MB, Gottdiener J, Gottlieb S, Justice AC, Leaf D, McGinnis K, Rimland D, Rodriguez‐Barradas M, Sico J, Skanderson M, Tindle H, Tracy RP, Warner A, Freiberg MS. HIV Infection and Cardiovascular Disease in Women. Journal Of The American Heart Association 2014, 3: e001035. PMID: 25324353, PMCID: PMC4323817, DOI: 10.1161/jaha.114.001035.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge DistributionAgedCardiovascular DiseasesCase-Control StudiesComorbidityConfidence IntervalsFemaleHIV InfectionsHumansLongitudinal StudiesMiddle AgedPrevalenceProportional Hazards ModelsProspective StudiesRisk AssessmentSeverity of Illness IndexSurvival AnalysisUnited StatesUser-Computer InterfaceVeteransConceptsRisk of CVDCVD eventsCardiovascular diseaseHIV infectionVeterans Aging Cohort StudyCox proportional hazards modelHIV uninfected womenIncident CVD eventsIncident cardiovascular diseaseIndependent risk factorAging Cohort StudyClinical Modification codesFirst clinical encounterDeath certificate dataProportional hazards modelSubstance use/abuseUse/abuseRace/ethnicityUninfected womenHepatitis CHIV- womenLast followCohort studyIschemic strokeUnstable anginaAdjudicated Morbidity and Mortality Outcomes by Age among Individuals with HIV Infection on Suppressive Antiretroviral Therapy
Miller CJ, Baker JV, Bormann AM, Erlandson KM, Huppler Hullsiek K, Justice AC, Neuhaus J, Paredes R, Petoumenos K, Wentworth D, Winston A, Wolfson J, Neaton JD, . Adjudicated Morbidity and Mortality Outcomes by Age among Individuals with HIV Infection on Suppressive Antiretroviral Therapy. PLOS ONE 2014, 9: e95061. PMID: 24728071, PMCID: PMC3984283, DOI: 10.1371/journal.pone.0095061.Peer-Reviewed Original ResearchConceptsSerious non-AIDS eventsNon-AIDS eventsComposite outcomeAntiretroviral therapyCardiovascular diseaseSuppressive combination antiretroviral therapyEnd-stage renal diseaseEndpoint review committeeFive-year KaplanNon-AIDS cancerCombination antiretroviral therapyHIV RNA levelsSerious adverse eventsSuppressive antiretroviral therapyCause of morbidityLarge international trialCause of deathStudies of interventionsPre-specified criteriaCause mortalityAdverse eventsAIDS eventsEffect of ageMeier estimatesBaseline factors
2012
HIV Status, Burden of Comorbid Disease, and Biomarkers of Inflammation, Altered Coagulation, and Monocyte Activation
Armah KA, McGinnis K, Baker J, Gibert C, Butt AA, Bryant KJ, Goetz M, Tracy R, Oursler KK, Rimland D, Crothers K, Rodriguez-Barradas M, Crystal S, Gordon A, Kraemer K, Brown S, Gerschenson M, Leaf DA, Deeks SG, Rinaldo C, Kuller LH, Justice A, Freiberg M. HIV Status, Burden of Comorbid Disease, and Biomarkers of Inflammation, Altered Coagulation, and Monocyte Activation. Clinical Infectious Diseases 2012, 55: 126-136. PMID: 22534147, PMCID: PMC3493182, DOI: 10.1093/cid/cis406.Peer-Reviewed Original ResearchConceptsBiomarkers of inflammationVeterans Aging Cohort StudyAltered coagulationMonocyte activationUninfected veteransCardiovascular diseaseElevated biomarkersComorbid conditionsHigh prevalenceCD4 cell countElevated IL-6Aging Cohort StudyOngoing HIV replicationPrevalent cardiovascular diseaseHIV-1 RNAHuman immunodeficiency virusCopies/mLElevated sCD14More dyslipidemiaCD4 countHepatitis CCohort studyComorbid diseasesCurrent smokingHIV infection
2011
Association of Age and Comorbidity with Physical Function in HIV-Infected and Uninfected Patients: Results from the Veterans Aging Cohort Study
Oursler KK, Goulet JL, Crystal S, Justice AC, Crothers K, Butt AA, Rodriguez-Barradas MC, Favors K, Leaf D, Katzel LI, Sorkin JD. Association of Age and Comorbidity with Physical Function in HIV-Infected and Uninfected Patients: Results from the Veterans Aging Cohort Study. AIDS Patient Care And STDs 2011, 25: 13-20. PMID: 21214375, PMCID: PMC3030913, DOI: 10.1089/apc.2010.0242.Peer-Reviewed Original ResearchConceptsChronic pulmonary diseaseAge-associated comorbiditiesPhysical functionUninfected patientsPulmonary diseaseUninfected subjectsSelf-reported physical functionVeterans Aging Cohort StudyAging of HIVHIV care guidelinesVeterans Aging CohortHIV clinical careAging Cohort StudyAssociation of ageCross-sectional analysisOlder HIVCohort studyHIV infectionHIV statusCare guidelinesPoor functionCardiovascular diseaseClinical carePhysical subscaleHIV
2010
The Association Between Alcohol Consumption and Prevalent Cardiovascular Diseases Among HIV-Infected and HIV-Uninfected Men
Freiberg MS, McGinnis KA, Kraemer K, Samet JH, Conigliaro J, Ellison R, Bryant K, Kuller LH, Justice AC. The Association Between Alcohol Consumption and Prevalent Cardiovascular Diseases Among HIV-Infected and HIV-Uninfected Men. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2010, 53: 247-253. PMID: 20009766, PMCID: PMC2858978, DOI: 10.1097/qai.0b013e3181c6c4b7.Peer-Reviewed Original ResearchConceptsPrevalent cardiovascular diseaseCardiovascular diseaseAlcohol consumptionHigh prevalenceAlcohol abuseHazardous drinkingRisk factorsOdds ratioModerate drinkingTraditional CVD risk factorsVeterans Aging Cohort StudyCVD risk factorsTraditional risk factorsAging Cohort StudyHIV-uninfected (HIV-) menHIV-InfectedSimilar HIVAntiretroviral therapyCD4 countCohort studyProspective cohortPast drinkersKidney diseaseHIVLogistic regression
2009
The Association Between the Receipt of Lipid Lowering Therapy and HIV Status Among Veterans Who Met NCEP/ATP III Criteria for the Receipt of Lipid Lowering Medication
Freiberg MS, Leaf DA, Goulet JL, Goetz MB, Oursler KK, Gibert CL, Rodriguez-Barradas MC, Butt AA, Justice AC. The Association Between the Receipt of Lipid Lowering Therapy and HIV Status Among Veterans Who Met NCEP/ATP III Criteria for the Receipt of Lipid Lowering Medication. Journal Of General Internal Medicine 2009, 24: 334-340. PMID: 19127386, PMCID: PMC2642578, DOI: 10.1007/s11606-008-0891-7.Peer-Reviewed Original ResearchConceptsNCEP/ATP III criteriaATP III criteriaHIV viral loadViral loadAdult Treatment Panel guidelinesHigher HIV viral loadFive-site studyLipid lowering medicationsVeterans Aging CohortHIV infection statusLipid-Lowering TherapyProspective observational cohortCross-sectional analysisHIV-HCVLowering therapiesModifiable mediatorsObservational cohortResultsThe prevalenceHIV infectionHIV statusPharmacy dataCardiovascular diseasePanel guidelinesMAIN OUTCOMELow prevalence