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 ResearchMeSH KeywordsAortic Aneurysm, AbdominalCardiovascular DiseasesCohort StudiesCross-Sectional StudiesHIV InfectionsHumansProspective StudiesRisk FactorsVeteransConceptsIncident 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
2022
Circulating T Cells and Cardiovascular Risk in People With and Without HIV Infection
Kundu S, Freiberg MS, Tracy RP, So-Armah KA, Koethe JR, Duncan MS, Tindle HA, Beckman JA, Feinstein MJ, McDonnell WJ, Justice A, Doyle MF, Study V. Circulating T Cells and Cardiovascular Risk in People With and Without HIV Infection. Journal Of The American College Of Cardiology 2022, 80: 1633-1644. PMID: 36265959, DOI: 10.1016/j.jacc.2022.08.756.Peer-Reviewed Original ResearchConceptsT cell subsetsT helper type 17 (Th17) cellsCVD risk factorsIncident CVD eventsType 17 cellsIncident CVDCell subsetsHIV infectionCVD eventsRisk factorsInternational ClassificationT effector memory cellsRe-expressing CD45RAEffector memory cellsSubset of CD4Cardiovascular disease riskProportional hazards regressionT helper cellsMedian participant ageLow CD4Cardiovascular riskObservational cohortPrevalent CVDCVD incidenceRevision diagnosisAnalysis of Postvaccination Breakthrough COVID-19 Infections Among Adults With HIV in the United States
Coburn SB, Humes E, Lang R, Stewart C, Hogan BC, Gebo KA, Napravnik S, Edwards JK, Browne LE, Park LS, Justice AC, Gordon KS, Horberg MA, Certa JM, Watson E, Jefferson CR, Silverberg MJ, Skarbinski J, Leyden WA, Williams CF, Althoff KN. Analysis of Postvaccination Breakthrough COVID-19 Infections Among Adults With HIV in the United States. JAMA Network Open 2022, 5: e2215934. PMID: 35671054, PMCID: PMC9175076, DOI: 10.1001/jamanetworkopen.2022.15934.Peer-Reviewed Original ResearchConceptsBreakthrough infectionsFull vaccinationAdditional doseSARS-CoV-2 infection riskBreakthrough COVID-19 infectionsCOVID-19 breakthrough infectionsHIV viral load suppressionInfection riskSARS-CoV-2 infectionBreakthrough infection riskHigher CD4 countsViral load suppressionHIV viral loadAdditional vaccine dosesCOVID-19 vaccinationCOVID-19 infectionIntegrated health systemNon-Hispanic blacksCOVID-19 vaccineSARS-CoV-2Non-Hispanic whitesExpansion of RecommendationsCOVID-19 diagnosisAdvanced diseaseCD4 countPeriods 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 ResearchMeSH KeywordsAgingCohort StudiesDisease ProgressionHIV InfectionsHumansIll-Housed PersonsProspective StudiesVeteransConceptsHIV 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
2021
Prostate Cancer Screening and Incidence among Aging Persons Living with HIV
Leapman MS, Stone K, Wadia R, Park LS, Gibert CL, Goetz MB, Bedimo R, Rodriguez-Barradas M, Shebl F, Justice AC, Brown ST, Crothers K, Sigel KM. Prostate Cancer Screening and Incidence among Aging Persons Living with HIV. Journal Of Urology 2021, 207: 324-332. PMID: 34555924, PMCID: PMC8741750, DOI: 10.1097/ju.0000000000002249.Peer-Reviewed Original ResearchConceptsPSA testingHIV statusProstate cancerProstate biopsyCancer incidenceHuman immunodeficiency virus statusProstate-specific antigen (PSA) testingVeterans Aging Cohort StudyProspective national cohortMultivariable Poisson modelsAging Cohort StudySpecific antigen testingHuman immunodeficiency virusProstate cancer screeningUninfected comparatorsCohort studyIncident cancerAntigen testingImmunodeficiency virusMean ageCancer screeningNational cohortCancer stageVirus statusMultivariable modelAssociation 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 ResearchMeSH KeywordsCardiovascular DiseasesCohort StudiesDepressionHIV InfectionsHumansIncidenceProspective StudiesRisk FactorsSmokingSyndemicVeteransConceptsIncident 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
Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms?
Caniglia EC, Stevens ER, Khan M, Young KE, Ban K, Marshall BDL, Chichetto NE, Gaither JR, Crystal S, Edelman EJ, Fiellin DA, Gordon AJ, Bryant KJ, Tate J, Justice AC, Braithwaite RS. Does Reducing Drinking in Patients with Unhealthy Alcohol Use Improve Pain Interference, Use of Other Substances, and Psychiatric Symptoms? Alcohol Clinical And Experimental Research 2020, 44: 2257-2265. PMID: 33030753, PMCID: PMC8077101, DOI: 10.1111/acer.14455.Peer-Reviewed Original ResearchConceptsUnhealthy alcohol useAlcohol usePain interferenceTobacco smokingUS veteransOdds ratioPsychiatric symptomsDepressive symptomsCocaine useVeterans Aging Cohort StudyAlcohol Use Disorders Identification Test (AUDIT) questionnaireCannabis useSubstance useAging Cohort StudyAnxiety symptomsSeparate logistic regression modelsChronic pain interferenceMultisite observational studyLogistic regression modelsCohort studyInverse probability weightingNext followObservational studyPotential selection biasYears postbaselineAll-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors
Gordon K, Manhapra A, Crystal S, Dziura J, Edelman E, Skanderson M, Kerns R, Justice A, Tate J, Becker W. All-cause mortality among males living with and without HIV initiating long-term opioid therapy, and its association with opioid dose, opioid interruption and other factors. Drug And Alcohol Dependence 2020, 216: 108291. PMID: 33011662, PMCID: PMC7644145, DOI: 10.1016/j.drugalcdep.2020.108291.Peer-Reviewed Original ResearchConceptsMorphine equivalent daily doseCause mortalityLong-term opioid therapyTime-updated Cox regressionStrong dose-response relationshipUnnatural deathsEquivalent daily doseDose-response relationshipOpioid doseOpioid therapyUninfected patientsOpioid useDaily doseCox regressionMortality outcomesTherapy doseHigh doseMale veteransOverdose fatalitiesOverdose mortalityPLWHMortalityHIVPatientsDoseDNA 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 periodCohortMortalityDrugsIndexBiomarkersSeverityExcess Weight Gain After Cure of Hepatitis C Infection with Direct-Acting Antivirals
Do A, Esserman DA, Krishnan S, Lim JK, Taddei TH, Hauser RG, Tate JP, Re VL, Justice AC. Excess Weight Gain After Cure of Hepatitis C Infection with Direct-Acting Antivirals. Journal Of General Internal Medicine 2020, 35: 2025-2034. PMID: 32342483, PMCID: PMC7352003, DOI: 10.1007/s11606-020-05782-6.Peer-Reviewed Original ResearchMeSH KeywordsAntiviral AgentsHepacivirusHepatitis CHepatitis C, ChronicHumansProspective StudiesTreatment OutcomeWeight GainConceptsDAA treatmentExcess weight gainTreatment initiationWeight gainChronic hepatitis C virus (HCV) infectionHigh FIB-4 scoreHepatitis C virus infectionC virus infectionFIB-4 scoreHepatitis C infectionDirect acting antiviralsLiver disease progressionMultiple logistic regressionConclusionWeight gainDAA therapySVR achievementC infectionBaseline weightProspective studyExcess weightDisease progressionVirus infectionHigh riskPatientsBirth cohortReceipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV
Shahrir S, Crothers K, McGinnis KA, Chan KCG, Baeten JM, Wilson SM, Butt AA, Pisani MA, Baldassarri SR, Justice A, Williams EC. Receipt and predictors of smoking cessation pharmacotherapy among veterans with and without HIV. Progress In Cardiovascular Diseases 2020, 63: 118-124. PMID: 31987807, PMCID: PMC7251937, DOI: 10.1016/j.pcad.2020.01.003.Peer-Reviewed Original ResearchMeSH KeywordsAgedAnti-HIV AgentsCardiovascular DiseasesFemaleHealth StatusHIV InfectionsHIV Long-Term SurvivorsHumansLongitudinal StudiesMaleMiddle AgedPreventive Health ServicesProspective StudiesProtective FactorsRisk AssessmentRisk FactorsRisk Reduction BehaviorSmokersSmokingSmoking CessationSmoking Cessation AgentsTime FactorsTreatment OutcomeUnited StatesVeterans HealthViral LoadConceptsNicotine replacement therapyVeterans Aging Cohort StudyMultivariable log-linear regression modelsPotential treatment disparitiesSmoking cessation pharmacotherapyPatient-level factorsAging Cohort StudyMental health disordersRates of receiptUninfected participantsUninfected patientsCardiovascular riskCessation pharmacotherapyCohort studyCurrent smokingHIV statusMultivariable analysisTreatment disparitiesReplacement therapyRelative riskHealth disordersPharmacotherapyPLWHSmokingHIV
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 factorsDNA Methylation Markers of Type 2 Diabetes Mellitus Among Male Veterans With or Without Human Immunodeficiency Virus Infection
Mathur R, Hui Q, Huang Y, Gwinn M, So-Armah K, Freiberg MS, Justice AC, Xu K, Marconi VC, Sun YV. DNA Methylation Markers of Type 2 Diabetes Mellitus Among Male Veterans With or Without Human Immunodeficiency Virus Infection. The Journal Of Infectious Diseases 2019, 219: 1959-1962. PMID: 30649532, PMCID: PMC6534194, DOI: 10.1093/infdis/jiz023.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virus (HIV) infectionHIV infection statusImmunodeficiency virus infectionVirus infectionVeterans Aging Cohort StudyType 2 diabetes mellitusInfection statusPancreatic β-cell functionAging Cohort StudyΒ-cell functionCohort studyDiabetes mellitusT2DM pathogenesisMale veteransType 2DNA methylation markersSuggestive interactionStatistical significanceMale participantsMellitusT2DMMethylation markersNovel associationsInfectionSuggestive statistical significance
2018
Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care
Barry DT, Marshall BDL, Becker WC, Gordon AJ, Crystal S, Kerns RD, Gaither JR, Gordon KS, Justice AC, Fiellin DA, Edelman EJ. Duration of opioid prescriptions predicts incident nonmedical use of prescription opioids among U.S. veterans receiving medical care. Drug And Alcohol Dependence 2018, 191: 348-354. PMID: 30176548, PMCID: PMC6596307, DOI: 10.1016/j.drugalcdep.2018.07.008.Peer-Reviewed Original ResearchConceptsPrescription opioid receiptPrescription opioidsMedical careOpioid receiptVeterans Health Administration primary careNonmedical useMultivariable Cox modelInfectious disease clinicProspective cohort studyProportional hazards regressionPrescription opioid medicationsPublic health problemSubstance use disordersMedication-related characteristicsOpioid therapyOpioid medicationsOpioid prescriptionsCohort studyDisease clinicMedian ageHazards regressionEligible participantsPrimary careRisk factorsIncidence rateAssociation of Viral Suppression With Lower AIDS-Defining and Non-AIDS-Defining Cancer Incidence in HIV-Infected Veterans: A Prospective Cohort Study.
Park LS, Tate JP, Sigel K, Brown ST, Crothers K, Gibert C, Goetz MB, Rimland D, Rodriguez-Barradas MC, Bedimo RJ, Justice AC, Dubrow R. Association of Viral Suppression With Lower AIDS-Defining and Non-AIDS-Defining Cancer Incidence in HIV-Infected Veterans: A Prospective Cohort Study. Annals Of Internal Medicine 2018, 169: 87-96. PMID: 29893768, PMCID: PMC6825799, DOI: 10.7326/m16-2094.Peer-Reviewed Original ResearchConceptsLong-term viral suppressionViral suppressionLong-term suppressionCancer incidenceCancer riskHIV treatment successLow viral suppressionViral suppression statusProspective cohort studyT-cell countsEffect of CD4HIV-positive veteransCancer incidence ratesNational InstituteNational Cancer InstituteAIDS definingNon-AIDSUninfected veteransAntiretroviral therapyExcess cancer riskProspective cohortCohort studyUninfected personsIncidence rateTreatment successBilirubin 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 levelsNonantiretroviral 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 systemAntiretroviralsOutcomesAssociationRiskCommonly Prescribed Antiretroviral Therapy Regimens and Incidence of AIDS-Defining Neurological Conditions
Caniglia EC, Phillips A, Porter K, Sabin CA, Winston A, Logan R, Gill J, Vandenhende MA, Barger D, Lodi S, Moreno S, Arribas JR, Pacheco A, Cardoso SW, Chrysos G, Gogos C, Abgrall S, Costagliola D, Meyer L, Seng R, van Sighem A, Reiss P, Muga R, Hoyos SP, Braun D, Hauser C, Barrufet P, Leyes M, Tate J, Justice A, Hernán MA. Commonly Prescribed Antiretroviral Therapy Regimens and Incidence of AIDS-Defining Neurological Conditions. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2018, 77: 102-109. PMID: 28991888, PMCID: PMC5720915, DOI: 10.1097/qai.0000000000001562.Peer-Reviewed Original ResearchMeSH KeywordsAcquired Immunodeficiency SyndromeAdultAIDS Dementia ComplexAIDS-Related Opportunistic InfectionsAlkynesAmericasAtazanavir SulfateBenzoxazinesCohort StudiesCyclopropanesDarunavirEuropeFemaleHIV Protease InhibitorsHumansLeukoencephalopathy, Progressive MultifocalLopinavirMaleMeningitis, CryptococcalMiddle AgedProspective StudiesReverse Transcriptase InhibitorsToxoplasmosisConceptsNucleoside reverse transcriptase inhibitor (NRTI) backboneReverse transcriptase inhibitor backboneHazard ratioNeurological conditionsInhibitor backbonePooled logistic modelCombined end pointRespective hazard ratiosProgressive multifocal leukoencephalopathyProspective cohort studyAntiretroviral therapy regimensHIV-positive individualsHIV-CAUSAL CollaborationIncidence of AIDSCART initiationHIV dementiaAntiretroviral therapyCART regimenCryptococcal meningitisMultifocal leukoencephalopathyClinical characteristicsCohort studyTherapy regimensAtazanavirLopinavir
2017
Increased Echocardiographic Pulmonary Pressure in HIV-infected and -uninfected Individuals in the Veterans Aging Cohort Study
Brittain EL, Duncan MS, Chang J, Patterson OV, DuVall SL, Brandt CA, So-Armah KA, Goetz M, Akgun K, Crothers K, Zola C, Kim J, Gibert C, Pisani M, Morris A, Hsue P, Tindle HA, Justice A, Freiberg M. Increased Echocardiographic Pulmonary Pressure in HIV-infected and -uninfected Individuals in the Veterans Aging Cohort Study. American Journal Of Respiratory And Critical Care Medicine 2017, 197: 923-932. PMID: 29131651, PMCID: PMC6020408, DOI: 10.1164/rccm.201708-1555oc.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyCD4 cell countHIV viral loadAging Cohort StudyUninfected veteransPulmonary pressurePrevalent comorbiditiesCohort studyViral loadHigh prevalenceCell countLow CD4 cell countsHigher HIV viral loadAntiretroviral therapy eraRisk of deathRace/ethnicityPASP valuesTherapy eraAdjusted riskPulmonary hypertensionObservational cohortPrognostic impactPrimary outcomeClinical featuresHIV status