2022
Potentially inappropriate medication use by level of polypharmacy among US Veterans 49–64 and 65–70 years old
Guillot J, Rentsch CT, Gordon KS, Justice AC, Bezin J. Potentially inappropriate medication use by level of polypharmacy among US Veterans 49–64 and 65–70 years old. Pharmacoepidemiology And Drug Safety 2022, 31: 1056-1074. PMID: 35780391, PMCID: PMC9464694, DOI: 10.1002/pds.5506.Peer-Reviewed Original ResearchConceptsLevel of polypharmacyRace/ethnicityPIM prevalencePrevalence of PIMsInappropriate medication useElectronic health recordsCommon PIMsPharmacy fillsPROMPT criteriaInappropriate medicationsOlder patientsMedication usePsychotropic medicationsRefill recordsPolypharmacyPatientsVeterans AffairsMedicationsPrevalenceHealth recordsFiscal year 2016AgeMeaningful differencesSexTarget ageDevelopment and Validation of a Model for Prediction of End-Stage Liver Disease in People With HIV
Kim HN, Nance RM, Re V, Silverberg MJ, Franco R, Sterling TR, Cachay ER, Horberg MA, Althoff KN, Justice AC, Moore RD, Klein M, Crane HM, Delaney JA, Kitahata MM. Development and Validation of a Model for Prediction of End-Stage Liver Disease in People With HIV. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2022, 89: 396-404. PMID: 35202048, PMCID: PMC8887786, DOI: 10.1097/qai.0000000000002886.Peer-Reviewed Original ResearchConceptsEnd-stage liver diseaseLiver diseaseNorth American AIDS Cohort CollaborationStandardized medical record reviewAccessible clinical parametersHIV-specific factorsChronic hepatitis BFibrosis-4 indexMedical record reviewSpontaneous bacterial peritonitisHarrell's C-statisticHepatitis B virusHepatitis C virusAlcohol use disorderRisk prediction modelRace/ethnicityCohort CollaborationESLD riskHepatic impairmentVariceal bleedHepatitis BBacterial peritonitisHepatic encephalopathyRecord reviewClinical parameters
2021
The shifting age distribution of people with HIV using antiretroviral therapy in the United States
Althoff KN, Stewart CN, Humes E, Zhang J, Gerace L, Boyd CM, Wong C, Justice AC, Gebo KA, Thorne JE, Rubtsova AA, Horberg MA, Silverberg MJ, Leng SX, Rebeiro PF, Moore RD, Buchacz K, Kasaie P. The shifting age distribution of people with HIV using antiretroviral therapy in the United States. AIDS 2021, 36: 459-471. PMID: 34750289, PMCID: PMC8795488, DOI: 10.1097/qad.0000000000003128.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyRace/ethnicityNorth American AIDS Cohort CollaborationHIV acquisition riskHIV Epidemic goalsOverall median ageSubgroups of sexRelative reductionAge distributionCohort CollaborationHIV diagnosisMedian ageRisk groupsUS CentersAcquisition riskHIVUS populationDisease controlSurveillance reportsDiscrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America
McGinnis KA, Justice AC, Moore RD, Silverberg MJ, Althoff KN, Karris M, Lima VD, Crane HM, Horberg MA, Klein MB, Gange SJ, Gebo KA, Mayor A, Tate JP, Benson C, Bosch R, Kirk G, Marconi V, Colasanti J, Mayer K, Grasso C, Hogg R, Lima V, Montaner J, Sereda P, Salters K, Buchacz K, Li J, Gebo K, Moore R, Moore R, Jacobson J, Horberg M, Silverberg M, Thorne J, Brown T, Tien P, D’Souza G, Smith G, Loutfy M, Gupta M, Klein M, Rabkin C, Kroch A, Burchell A, Betts A, Lindsay J, Nijhawan A, Mayor A, Gill M, Martin J, Li J, Brooks J, Saag M, Mugavero M, Willig J, Bamford L, Karris M, Eron J, Napravnik S, Kitahata M, Crane H, Sterling T, Haas D, Rebeiro P, Turner M, McGinnis K, Justice A, Moore R, Althoff K, Gange S, Kitahata M, Lee J, Saag M, Horberg M, Klein M, McKaig R, Freeman A, Moore R, Althoff K, Freeman A, Kitahata M, Van Rompaey S, Crane H, Morton L, McReynolds J, Lober W, Gange S, Lee J, Hogan B, You B, Humes E, Gerace L, Stewart C, Coburn S. Discrimination and Calibration of the Veterans Aging Cohort Study Index 2.0 for Predicting Mortality Among People With Human Immunodeficiency Virus in North America. Clinical Infectious Diseases 2021, 75: 297-304. PMID: 34609485, PMCID: PMC9410720, DOI: 10.1093/cid/ciab883.Peer-Reviewed Original ResearchConceptsNorth American AIDS Cohort CollaborationVACS Index 2.0National Death IndexHIV-1 RNAHuman immunodeficiency virusCopies/mLRisk of mortalityRace/ethnicityCohort CollaborationNA-ACCORDCause mortalityCD4 countMedian ageDeath IndexImmunodeficiency virusPredicting MortalityMortality ascertainmentMortality rateMortalitySpecific biomarkersPWHDiverse cohortObserved mortalityCohortHIVHIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death
Freiberg MS, Duncan MS, Alcorn C, Chang C, Kundu S, Mumpuni A, Smith EK, Loch S, Bedigian A, Vittinghoff E, So‐Armah K, Hsue PY, Justice AC, Tseng ZH. HIV Infection and the Risk of World Health Organization–Defined Sudden Cardiac Death. Journal Of The American Heart Association 2021, 10: e021268. PMID: 34493058, PMCID: PMC8649505, DOI: 10.1161/jaha.121.021268.Peer-Reviewed Original ResearchConceptsHIV viral loadCD4 cell countFirst clinical visitHIV infectionViral loadSCD riskCell countWorld Health OrganizationCopies/Elevated HIV viral loadLow CD4 cell countsSudden cardiac death rateVeterans Aging Cohort StudyCox proportional hazards regressionHealth OrganizationConclusions HIV infectionSCD risk factorsCardiac death rateAging Cohort StudyProportional hazards regressionSudden cardiac deathCells/Mean baseline ageRace/ethnicityCohort studyMortality Among Persons Entering HIV Care Compared With the General U.S. Population : An Observational Study.
Edwards JK, Cole SR, Breger TL, Rudolph JE, Filiatreau LM, Buchacz K, Humes E, Rebeiro PF, D'Souza G, Gill MJ, Silverberg MJ, Mathews WC, Horberg MA, Thorne J, Hall HI, Justice A, Marconi VC, Lima VD, Bosch RJ, Sterling TR, Althoff KN, Moore RD, Saag M, Eron JJ. Mortality Among Persons Entering HIV Care Compared With the General U.S. Population : An Observational Study. Annals Of Internal Medicine 2021, 174: 1197-1206. PMID: 34224262, PMCID: PMC8453103, DOI: 10.7326/m21-0065.Peer-Reviewed Original ResearchConceptsGeneral U.S. populationHIV careU.S. populationNorth American AIDS Cohort CollaborationHIV clinical careObservational cohort studyTreatment of adultsRace/ethnicityCohort CollaborationCause mortalityCohort studyHIV infectionModifiable factorsComparable personsObservational studyClinical careHigh riskGeneral populationSociodemographic factorsHealth StatisticsMortalityHIVKaplan-Meier estimatorCareFive yearsFactors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis
Hahn JA, Murnane PM, Vittinghoff E, Muyindike WR, Emenyonu NI, Fatch R, Chamie G, Haberer JE, Francis JM, Kapiga S, Jacobson K, Myers B, Couture MC, DiClemente RJ, Brown JL, So-Armah K, Sulkowski M, Marcus GM, Woolf-King S, Cook RL, Richards VL, Molina P, Ferguson T, Welsh D, Piano MR, Phillips SA, Stewart S, Afshar M, Page K, McGinnis K, Fiellin DA, Justice AC, Bryant K, Saitz R. Factors associated with phosphatidylethanol (PEth) sensitivity for detecting unhealthy alcohol use: An individual patient data meta‐analysis. Alcohol Clinical And Experimental Research 2021, 45: 1166-1187. PMID: 33837975, PMCID: PMC8254773, DOI: 10.1111/acer.14611.Peer-Reviewed Original ResearchConceptsIndividual participant dataUnhealthy alcohol useRace/ethnicitySelf-reported alcohol useAlcohol useBiologic variablesHigher oddsAlcohol consumptionBlood collectionAdvanced liver fibrosisUnhealthy alcohol consumptionIndividual patient dataAUDIT-C scoresAssociation of sexAfrican AmericansHigher BMILiver fibrosisEligible studiesHigher hemoglobinClinical careLower oddsAlcohol metabolitesParticipant dataPatient dataMixed effects modelsThe relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system
Satre DD, Levine-Hall T, Sterling SA, Young-Wolff KC, Lam JO, Alexeeff S, Hojilla JC, Williams A, Justice AC, Sterne J, Cavassini M, Bryant KJ, Williams EC, Horberg MA, Volberding P, Weisner C, Silverberg MJ. The relationship of smoking and unhealthy alcohol use to the HIV care continuum among people with HIV in an integrated health care system. Drug And Alcohol Dependence 2021, 219: 108481. PMID: 33429295, PMCID: PMC7869693, DOI: 10.1016/j.drugalcdep.2020.108481.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useHIV care continuum outcomesIntegrated health care systemCare continuum outcomesAlcohol useHealth care systemContinuum outcomesCare continuumOdds ratioHigher oddsKaiser Permanente Northern CaliforniaCare systemHIV RNA controlPrimary care screeningHIV care continuumRelationship of smokingAdjusted odds ratioSeparate logistic regression modelsLogistic regression modelsRace/ethnicityHIV careHIV RNASmoking statusMean ageCare screening
2020
Development and validation of a 30-day mortality index based on pre-existing medical administrative data from 13,323 COVID-19 patients: The Veterans Health Administration COVID-19 (VACO) Index
King JT, Yoon JS, Rentsch CT, Tate JP, Park LS, Kidwai-Khan F, Skanderson M, Hauser RG, Jacobson DA, Erdos J, Cho K, Ramoni R, Gagnon DR, Justice AC. Development and validation of a 30-day mortality index based on pre-existing medical administrative data from 13,323 COVID-19 patients: The Veterans Health Administration COVID-19 (VACO) Index. PLOS ONE 2020, 15: e0241825. PMID: 33175863, PMCID: PMC7657526, DOI: 10.1371/journal.pone.0241825.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity IndexVeterans Health AdministrationVACO IndexValidation cohortMedical administrative dataDevelopment cohortSARS-CoV-2 testing resultsMortality indexICD-10 diagnosis codesUS Veterans Health AdministrationSARS-CoV-2 infectionPre-existing medical conditionsCOVID-19 mortality riskPeripheral vascular diseaseCOVID-19 patientsCOVID-19 infectionCOVID-19 mortalitySARS-CoV-2Administrative dataLogistic regression modelsRace/ethnicityCohort subgroupsComorbidity indexOverall mortalityComorbid conditionsHealth System‐Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV
Silverberg MJ, Levine‐Hall T, Hood N, Anderson AN, Alexeeff SE, Lam JO, Slome SB, Flamm JA, Hare C, Ross T, Justice A, Sterne JAC, Williams A, Bryant KJ, Weisner CM, Horberg MA, Sterling SA, Satre DD. Health System‐Based Unhealthy Alcohol Use Screening and Treatment Comparing Demographically Matched Participants With and Without HIV. Alcohol Clinical And Experimental Research 2020, 44: 2545-2554. PMID: 33067802, PMCID: PMC7725961, DOI: 10.1111/acer.14481.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol use screeningHIV statusBrief interventionRace/ethnicityAlcohol useSpecialty visitsHazard ratioPrevalence ratiosLarge integrated healthcare systemCharlson Comorbidity IndexSpecialty care visitsProportional hazards modelIntegrated healthcare systemOutcomes of timeSubstance use disordersAddiction specialty careNeighborhood deprivation indexElectronic health recordsComorbidity indexAdult PLWHCare visitsCohort studyOutpatient visitsSignificant morbidityPatterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study
Rentsch CT, Kidwai-Khan F, Tate JP, Park LS, King JT, Skanderson M, Hauser RG, Schultze A, Jarvis CI, Holodniy M, Re V, Akgün KM, Crothers K, Taddei TH, Freiberg MS, Justice AC. Patterns of COVID-19 testing and mortality by race and ethnicity among United States veterans: A nationwide cohort study. PLOS Medicine 2020, 17: e1003379. PMID: 32960880, PMCID: PMC7508372, DOI: 10.1371/journal.pmed.1003379.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBetacoronavirusBlack or African AmericanClinical Laboratory TechniquesCohort StudiesCoronavirus InfectionsCOVID-19COVID-19 TestingEthnicityFemaleHispanic or LatinoHumansMaleMiddle AgedPandemicsPneumonia, ViralRetrospective StudiesSARS-CoV-2United StatesVeteransWhite PeopleYoung AdultConceptsCOVID-19 testingRace/ethnicityCohort studyWhite individualsSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectionAcute respiratory syndrome coronavirus 2 infectionSyndrome coronavirus 2 infectionSARS-CoV-2 infectionCOVID-19Large integrated healthcare systemCoronavirus 2 infectionNationwide cohort studyRetrospective cohort studyCoronavirus disease 2019Site of careIntegrated healthcare systemNon-Hispanic blacksPositive test resultsNon-Hispanic whitesClinical characteristicsMultivariable adjustmentComorbid conditionsMedication historyEthnic minority communitiesDisease 2019Impact of behavioral and medication treatment for alcohol use disorder on changes in HIV-related outcomes among patients with HIV: A longitudinal analysis
McGinnis KA, Skanderson M, Edelman EJ, Gordon AJ, Korthuis PT, Oldfield B, Williams EC, Wyse J, Bryant K, Fiellin DA, Justice AC, Kraemer KL. Impact of behavioral and medication treatment for alcohol use disorder on changes in HIV-related outcomes among patients with HIV: A longitudinal analysis. Drug And Alcohol Dependence 2020, 217: 108272. PMID: 32971391, PMCID: PMC7757793, DOI: 10.1016/j.drugalcdep.2020.108272.Peer-Reviewed Original ResearchConceptsAlcohol use disorderDetectable VLVisits/monthUse disordersVeterans Aging Cohort Study (VACS) dataCohort study dataRace/ethnicityUndetectable VLMedian ageTreatment initiationMedication treatmentImproved adherenceHIVBehavioral treatmentFirst monthIntensity groupTreatment intensityMonthsImpact of BehavioralOutcomesLinear regression modelsLongitudinal analysisVisitsVLAdherenceTiming of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus
Silverberg MJ, Leyden W, Hernández-Ramírez RU, Qin L, Lin H, Justice AC, Hessol NA, Achenbach CJ, D’Souza G, Engels EA, Althoff KN, Mayor AM, Sterling TR, Kitahata MM, Bosch RJ, Saag MS, Rabkin CS, Horberg MA, Gill MJ, Grover S, Mathews WC, Li J, Crane HM, Gange SJ, Lau B, Moore RD, Dubrow R, Neugebauer RS. Timing of Antiretroviral Therapy Initiation and Risk of Cancer Among Persons Living With Human Immunodeficiency Virus. Clinical Infectious Diseases 2020, 72: 1900-1909. PMID: 32785640, PMCID: PMC8315132, DOI: 10.1093/cid/ciaa1046.Peer-Reviewed Original ResearchConceptsVirus-related cancersEarly antiretroviral therapyHuman immunodeficiency virusAntiretroviral therapyART initiationImmunodeficiency virusNorth American AIDS Cohort CollaborationART-naive PLWHEarly ART initiationAntiretroviral therapy initiationHIV transmission riskNon-Hodgkin lymphomaCancer registry linkageRisk of cancerMarginal structural modelsRace/ethnicityCohort CollaborationTherapy initiationChart reviewIncident cancerRegistry linkageViral hepatitisTime-dependent confoundingCancer groupViral etiologySafety of Gabapentin Prescribed for Any Indication in a Large Clinical Cohort of 571,718 US Veterans with and without Alcohol Use Disorder
Rentsch CT, Morford KL, Fiellin DA, Bryant KJ, Justice AC, Tate JP. Safety of Gabapentin Prescribed for Any Indication in a Large Clinical Cohort of 571,718 US Veterans with and without Alcohol Use Disorder. Alcohol Clinical And Experimental Research 2020, 44: 1807-1815. PMID: 32628784, PMCID: PMC7540277, DOI: 10.1111/acer.14408.Peer-Reviewed Original ResearchConceptsAlcohol use disorderMental statusRelative riskGabapentin exposureUse disordersICD-9 diagnostic codesAdverse neurologic effectsPotential medication interactionsAltered mental statusIncidence of fallsClear dose-response relationshipLarge clinical cohortDose-response relationshipRace/ethnicityUnexposed patientsHepatitis CAdverse eventsMedication interactionsExcess riskNeurologic effectsUS veteransDiagnostic codesIncidence rateClinical cohortHigh riskPredicting prostate cancer death among 98,994 veterans: Differences by race/ethnicity.
Janet T, Danciu I, Justice A, Leapman M, McMahon B, Wadia R. Predicting prostate cancer death among 98,994 veterans: Differences by race/ethnicity. Journal Of Clinical Oncology 2020, 38: e17609-e17609. DOI: 10.1200/jco.2020.38.15_suppl.e17609.Peer-Reviewed Original ResearchProstate cancer deathNon-Hispanic blacksNon-Hispanic whitesVeterans Affairs Healthcare SystemRace/ethnicityHazard ratioGleason scoreCancer deathProstate cancerU.S. Veterans Affairs healthcare systemProstate cancer disease progressionDistant metastatic diseaseProstate cancer mortalityCancer disease progressionLocalized diseasePSA levelsMedian ageMetastatic diseaseLymph nodesPrognostic indexCancer mortalityTumor stageDisease progressionCox modelAge strata
2019
343. T-cell Subsets Associated with Diabetes in Veterans with and without HIV
Bailin S, McGinnis K, McDonnell W, So-Armah K, Wellons M, Doyle M, Mallal S, Justice A, Freiberg M, Koethe J. 343. T-cell Subsets Associated with Diabetes in Veterans with and without HIV. Open Forum Infectious Diseases 2019, 6: s182-s183. PMCID: PMC6810455, DOI: 10.1093/ofid/ofz360.416.Peer-Reviewed Original ResearchVeterans Aging Cohort StudyT cell subsetsPrevalent diabetesT cellsHIV statusMemory CD4Immune activationNaïve CD8VA electronic medical recordsMultivariate logistic regression modelAdaptive immune activationAdaptive immune profileT effector memoryChronic immune activationEffector memory cellsAging Cohort StudyCentral memory cellsMemory T cellsBody mass indexICD-9 codesPeripheral mononuclear cellsUnhealthy alcohol useElectronic medical recordsLogistic regression modelsRace/ethnicityOpioid use trajectory groups and changes in a physical health biomarker among HIV-positive and uninfected patients receiving opioid agonist treatment
McGinnis KA, Fiellin DA, Skanderson M, Hser YI, Lucas GM, Justice AC, Tate JP, Group F. Opioid use trajectory groups and changes in a physical health biomarker among HIV-positive and uninfected patients receiving opioid agonist treatment. Drug And Alcohol Dependence 2019, 204: 107511. PMID: 31546119, PMCID: PMC6993986, DOI: 10.1016/j.drugalcdep.2019.06.014.Peer-Reviewed Original ResearchConceptsOpioid agonist treatmentHIV-1 RNADetectable HIV-1 RNAUninfected patientsAgonist treatmentVeterans Aging Cohort StudyResponsiveness of CD4Substance use disorder treatmentHealth effectsUrine toxicology resultsUrine toxicology testsAging Cohort StudyElectronic health record dataUse disorder treatmentHealth record dataPhysical health effectsRace/ethnicityOAT initiationCohort studyOpioid useBiomarker changesToxicology resultsNegative groupUninfected individualsDisorder treatmentMeasuring Exposure to Incarceration Using the Electronic Health Record
Wang EA, Long JB, McGinnis KA, Wang KH, Wildeman CJ, Kim C, Bucklen KB, Fiellin DA, Bates J, Brandt C, Justice AC. Measuring Exposure to Incarceration Using the Electronic Health Record. Medical Care 2019, 57: s157-s163. PMID: 31095055, PMCID: PMC8352066, DOI: 10.1097/mlr.0000000000001049.Peer-Reviewed Original ResearchMeSH KeywordsAdministrative Claims, HealthcareAdultCohort StudiesElectronic Health RecordsEthnicityFemaleHumansInformation Storage and RetrievalMaleMedicareMiddle AgedNatural Language ProcessingPrisonersSelf ReportSensitivity and SpecificityUnited StatesUnited States Department of Veterans AffairsVeteransConceptsVeterans Aging Cohort StudyElectronic health recordsHuman immunodeficiency virus-infected patientsVHA electronic health recordsNational observational cohortVirus-infected patientsHealth recordsAging Cohort StudyEHR dataHealth care disparitiesAdministrative dataRace/ethnicityIncarceration exposureObservational cohortUninfected patientsCohort studySpecificity 99.3DATA SOURCESCare disparitiesSpecificity 100Specificity 98.9Social determinantsMedicaid ServicesSpecificity 95.9Health informationAssociation of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV
Edelman EJ, Gordon KS, Crothers K, Akgün K, Bryant KJ, Becker WC, Gaither JR, Gibert CL, Gordon AJ, Marshall BDL, Rodriguez-Barradas MC, Samet JH, Justice AC, Tate JP, Fiellin DA. Association of Prescribed Opioids With Increased Risk of Community-Acquired Pneumonia Among Patients With and Without HIV. JAMA Internal Medicine 2019, 179: 297-304. PMID: 30615036, PMCID: PMC6439696, DOI: 10.1001/jamainternmed.2018.6101.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyCommunity-acquired pneumoniaImmunosuppressive propertiesPrescribed opioidsCaP riskHIV statusMedian morphine equivalent daily doseVeterans Health Administration medical centersMorphine equivalent daily doseEquivalent daily doseAging Cohort StudyCase-control studyImmune-related outcomesRace/ethnicityIndex dateOpioid exposureCohort studyDaily doseOpioid propertiesStratified analysisMedical CenterMAIN OUTCOMEOpioidsMedicaid dataHIV
2018
Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals
Justice AC, Gordon KS, Skanderson M, Edelman EJ, Akgün KM, Gibert CL, Re V, Rimland D, Womack JA, Wyatt CM, Tate JP, Team V. Nonantiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals. AIDS 2018, 32: 739-749. PMID: 29543653, PMCID: PMC5868488, DOI: 10.1097/qad.0000000000001756.Peer-Reviewed Original ResearchConceptsAdverse health outcomesHIV statusUninfected individualsVACS IndexMedication countUS Veterans Affairs Healthcare SystemHealth outcomesVeterans Affairs Healthcare SystemRisk of hospitalizationSeverity of illnessHIV-1 RNAHIV-positive individualsRisk of mortalityDose responseRace/ethnicityPolypharmacyFiscal year 2009HospitalizationMedicationsMortalityHealthcare systemAntiretroviralsOutcomesAssociationRisk