2024
The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study.
Althoff K, Stewart C, Humes E, Gerace L, Boyd C, Gebo K, Justice A, Hyle E, Coburn S, Lang R, Silverberg M, Horberg M, Lima V, Gill M, Karris M, Rebeiro P, Thorne J, Rich A, Crane H, Kitahata M, Rubtsova A, Wong C, Leng S, Marconi V, D'Souza G, Kim H, Napravnik S, McGinnis K, Kirk G, Sterling T, Moore R, Kasaie P. The forecasted prevalence of comorbidities and multimorbidity in people with HIV in the United States through the year 2030: A modeling study. PLOS Medicine 2024, 21: e1004325. PMID: 38215160, PMCID: PMC10833859, DOI: 10.1371/journal.pmed.1004325.Peer-Reviewed Original ResearchConceptsHistory of injection drug useInjection drug useHealthcare needsPrevalence of comorbiditiesHIV diagnosisNorth American AIDS Cohort CollaborationDrug useAntiretroviral therapyHIV surveillance dataGuideline-recommended careNon-Hispanic whitesPrevalence of anxietyChronic kidney diseaseMyocardial infarctionPrevalence of cancerEnd-stage liver diseaseResearch and DesignMultimorbidity prevalenceRisk of comorbiditiesUnited StatesBlack MSMNon-HispanicSubspecialty careClinical capacityHIV clinicians
2021
Incident Rheumatoid Arthritis in HIV Infection: Epidemiology and Treatment
Hanberg JS, Hsieh E, Akgün KM, Weinstein E, Fraenkel L, Justice AC, Team T. Incident Rheumatoid Arthritis in HIV Infection: Epidemiology and Treatment. Arthritis & Rheumatology 2021, 73: 2189-2199. PMID: 34042306, DOI: 10.1002/art.41802.Peer-Reviewed Original ResearchConceptsDisease-modifying antirheumatic drugsIncident rheumatoid arthritisDiagnosis of RARA patientsRheumatoid arthritisRheumatoid factorUninfected individualsRheumatology/European AllianceHigh titersVeterans Aging Cohort StudyRA-specific autoantibodiesRheumatology 2010 criteriaTenth Revision codesAging Cohort StudyIncidence rate ratiosHigh autoantibody titersICD-10 codesDMARD useUninfected veteransAntirheumatic drugsAutoantibody titersCohort studyImmunosuppressed populationHIV infectionMedical chartsNIH Workshop on HIV-Associated Comorbidities, Coinfections, and Complications: Summary and Recommendation for Future Research.
Pahwa S, Deeks S, Zou S, Tomitch N, Miller-Novak L, Caler E, Justice A, Sacktor N, Gabuzda D, Hunt PW, Brown T, Kurth A, Baral S, Mugavero M, Mayer KH, Mendenhall E, Detels R, Mutabazi V. NIH Workshop on HIV-Associated Comorbidities, Coinfections, and Complications: Summary and Recommendation for Future Research. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2021, 86: 11-18. PMID: 33306561, PMCID: PMC7982002, DOI: 10.1097/qai.0000000000002528.Peer-Reviewed Original ResearchConceptsPotent antiretroviral therapyImplementation science researchBasic science researchAIDS comorbiditiesAntiretroviral therapyMiddle-income countriesClinical researchHealthy agingSyndemics researchHealth spanNIH workshopComorbiditiesComplicationsHIVPWHNormal lifespanCoinfectionIncome countriesNIHPressing gapsPotential prioritiesInvestigatorsPopulation researchRegimensWG members
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 conditionsSerious Falls in Middle‐Aged Veterans: Development and Validation of a Predictive Risk Model
Womack JA, Murphy TE, Bathulapalli H, Smith A, Bates J, Jarad S, Redeker NS, Luther SL, Gill TM, Brandt CA, Justice AC. Serious Falls in Middle‐Aged Veterans: Development and Validation of a Predictive Risk Model. Journal Of The American Geriatrics Society 2020, 68: 2847-2854. PMID: 32860222, PMCID: PMC7744431, DOI: 10.1111/jgs.16773.Peer-Reviewed Original ResearchConceptsMiddle-aged veteransVeterans Health AdministrationOpioid useSerious fallsAlcohol Use Disorders Identification Test-Consumption scoresCategory-free net reclassification improvementIllicit substance use disordersMental health comorbiditiesPrescription opioid useMultivariable logistic regressionNet reclassification improvementSubstance use disordersQuality of lifeHazardous alcohol usePredictive risk modelChronic medicationsCohort studyHealth comorbiditiesNinth RevisionReclassification improvementGeriatric healthInjury codesHazardous alcoholInternational ClassificationUse disordersSafety 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 risk
2019
Harvard HIV and Aging Workshop: Perspectives and Priorities from Claude D. Pepper Centers and Centers for AIDS Research
Montano M, Bhasin S, D'Aquila RT, Erlandson KM, Evans WJ, Funderburg NT, Justice A, Ndhlovu LC, Ojikutu B, Pahor M, Pahwa S, Ryan AS, Schrack J, Schultz M, Sebastiani P, Sinclair DA, Tripp J, Walker B, Womack J, Yung R, Reeves RK. Harvard HIV and Aging Workshop: Perspectives and Priorities from Claude D. Pepper Centers and Centers for AIDS Research. AIDS Research And Human Retroviruses 2019, 35: 999-1012. PMID: 31456412, PMCID: PMC6862961, DOI: 10.1089/aid.2019.0130.Peer-Reviewed Original ResearchComparison 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 factorsAssociation Between Gabapentin Receipt for Any Indication and Alcohol Use Disorders Identification Test—Consumption Scores Among Clinical Subpopulations With and Without Alcohol Use Disorder
Rentsch CT, Fiellin DA, Bryant KJ, Justice AC, Tate JP. Association Between Gabapentin Receipt for Any Indication and Alcohol Use Disorders Identification Test—Consumption Scores Among Clinical Subpopulations With and Without Alcohol Use Disorder. Alcohol Clinical And Experimental Research 2019, 43: 522-530. PMID: 30620410, PMCID: PMC6397056, DOI: 10.1111/acer.13953.Peer-Reviewed Original ResearchConceptsAlcohol use disorderAlcohol Use Disorders Identification Test-Consumption scoresAUDIT-C scoresAlcohol consumptionUnexposed patientsClinical trialsUse disordersBaseline levelsVeterans Aging Cohort StudyDoses of gabapentinAging Cohort StudyImpact of gabapentinSubstance use treatmentDifferences linear regression modelGabapentin doseCohort studyCurrent medicationsBaseline auditMultivariable differenceClinical indicationsAUD historyPatientsGabapentinClinical subpopulationsConsecutive days
2018
Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV
Bensley KM, McGinnis KA, Fiellin DA, Gordon AJ, Kraemer KL, Bryant KJ, Edelman EJ, Crystal S, Gaither JR, Korthuis PT, Marshall BDL, Ornelas IJ, Chan KCG, Dombrowski JC, Fortney JC, Justice AC, Williams EC. Racial/ethnic differences in the association between alcohol use and mortality among men living with HIV. Addiction Science & Clinical Practice 2018, 13: 2. PMID: 29353555, PMCID: PMC6389249, DOI: 10.1186/s13722-017-0103-z.Peer-Reviewed Original ResearchConceptsLow-risk alcohol useMortality riskAlcohol useRace/ethnicityWhite PLWHMortality rateAlcohol Use Disorders Identification Test-Consumption (AUDIT-C) questionnaireVeterans Aging Cohort StudyCox proportional hazards modelHigh-risk alcohol useAUDIT-C screeningAging Cohort StudyElectronic health record dataRisk of mortalityHigh-risk relativesUnhealthy alcohol useHigher mortality riskProportional hazards modelHealth record dataHigh mortality rateEthnic groupsMale PLWHCohort studyWhite patientsGeneral outpatients
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 statusHIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer
Taylor BS, So-Armah K, Tate JP, Marconi VC, Koethe JR, Bedimo RJ, Butt AA, Gibert CL, Goetz MB, Rodriguez-Barradas MC, Womack JA, Gerschenson M, Lo Re V, Rimland D, Yin MT, Leaf D, Tracy RP, Justice AC, Freiberg MS. HIV and Obesity Comorbidity Increase Interleukin 6 but Not Soluble CD14 or D-Dimer. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2017, 75: 500-508. PMID: 28696344, PMCID: PMC5513170, DOI: 10.1097/qai.0000000000001444.Peer-Reviewed Original ResearchConceptsIL-6Nonobese/Obese/D-dimerMedian IL-6 levelHIV status groupsElevated IL-6D-dimer levelsIL-6 levelsBody mass indexLogistic regression modelsElevated sCD14Uninfected participantsSCD14 levelsHIV infectionProinflammatory stateHIV statusInflammation increasesMass indexObesity/Soluble CD14Interleukin-6Obesity prevalenceOdds ratioInclusion criteriaIncreased 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 populationMeasuring Multimorbidity: A Risky Business
Bastian LA, Brandt CA, Justice AC. Measuring Multimorbidity: A Risky Business. Journal Of General Internal Medicine 2017, 32: 959-960. PMID: 28653231, PMCID: PMC5570755, DOI: 10.1007/s11606-017-4110-2.Peer-Reviewed Original Research
2015
Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study.
Silverberg MJ, Lau B, Achenbach CJ, Jing Y, Althoff KN, D'Souza G, Engels EA, Hessol NA, Brooks JT, Burchell AN, Gill MJ, Goedert JJ, Hogg R, Horberg MA, Kirk GD, Kitahata MM, Korthuis PT, Mathews WC, Mayor A, Modur SP, Napravnik S, Novak RM, Patel P, Rachlis AR, Sterling TR, Willig JH, Justice AC, Moore RD, Dubrow R. Cumulative Incidence of Cancer Among Persons With HIV in North America: A Cohort Study. Annals Of Internal Medicine 2015, 163: 507-18. PMID: 26436616, PMCID: PMC4711936, DOI: 10.7326/m14-2768.Peer-Reviewed Original ResearchConceptsAge 75 yearsNon-Hodgkin lymphomaCumulative cancer incidenceCumulative incidenceLung cancerKaposi's sarcomaCalendar trendsCohort studyHIV statusHodgkin's lymphomaCancer incidenceLiver cancerNorth American AIDS Cohort CollaborationOral cavity/pharyngeal cancerHigher cumulative incidenceMortality rate trendsCohort CollaborationAnal cancerAntiretroviral therapyPharyngeal cancerSmoking cessationColorectal cancerLifetime riskIncidence trendsUninfected adultsDepression and Human Immunodeficiency Virus Infection Are Risk Factors for Incident Heart Failure Among Veterans
White JR, Chang CC, So-Armah KA, Stewart JC, Gupta SK, Butt AA, Gibert CL, Rimland D, Rodriguez-Barradas MC, Leaf DA, Bedimo RJ, Gottdiener JS, Kop WJ, Gottlieb SS, Budoff MJ, Khambaty T, Tindle HA, Justice AC, Freiberg MS. Depression and Human Immunodeficiency Virus Infection Are Risk Factors for Incident Heart Failure Among Veterans. Circulation 2015, 132: 1630-1638. PMID: 26358261, PMCID: PMC4624488, DOI: 10.1161/circulationaha.114.014443.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgingAntidepressive AgentsAnti-HIV AgentsCardiovascular DiseasesComorbidityDepressive Disorder, MajorDiabetes MellitusElectronic Health RecordsEthnicityFemaleFollow-Up StudiesHeart FailureHIV InfectionsHumansHyperlipidemiasIncidenceKidney DiseasesMaleMiddle AgedProspective StudiesRisk FactorsSubstance-Related DisordersUnited StatesVeteransConceptsMajor depressive disorderRisk factorsHuman immunodeficiency virus (HIV) infectionCox proportional hazards modelBaseline antidepressant useIncident HF eventsRisk of HFIncident heart failureImmunodeficiency virus infectionIndependent risk factorCohort Study participantsHeart failure riskProportional hazards modelHF morbidityCommon comorbiditiesIncident HFAntidepressant useHeart failureHIV infectionHIV- participantsPrimary outcomeNinth RevisionHF eventsMedical recordsDepressive disorderHIV 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 sitesHIVInfectionStrokePrimary Care of Women Aging with HIV
Womack JA, Brandt CA, Justice AC. Primary Care of Women Aging with HIV. Journal Of Midwifery & Women's Health 2015, 60: 146-157. PMID: 25782848, PMCID: PMC5031409, DOI: 10.1111/jmwh.12236.Peer-Reviewed Original ResearchAlcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011
Rentsch C, Tate JP, Akgün KM, Crystal S, Wang KH, Ryan Greysen S, Wang EA, Bryant KJ, Fiellin DA, Justice AC, Rimland D. Alcohol-Related Diagnoses and All-Cause Hospitalization Among HIV-Infected and Uninfected Patients: A Longitudinal Analysis of United States Veterans from 1997 to 2011. AIDS And Behavior 2015, 20: 555-564. PMID: 25711299, PMCID: PMC4550577, DOI: 10.1007/s10461-015-1025-y.Peer-Reviewed Original ResearchConceptsAlcohol-related diagnosesHospitalization ratesUnited States veteransUninfected patientsCause hospitalizationHIV infectionStates veteransUninfected individualsMultivariable Cox proportional hazards modelsCox proportional hazards modelOverall hospitalization rateProportional hazards modelCancer admissionsAntiretroviral therapyMultivariable adjustmentHIV serostatusComorbidity variablesHospitalization trendsRelative riskHigh riskHazards modelHIVHospitalizationDisease categoriesPatients
2014
Increased Risk of Radiographic Emphysema in HIV Is Associated With Elevated Soluble CD14 and Nadir CD4
Attia EF, Akgün KM, Wongtrakool C, Goetz MB, Rodriguez-Barradas MC, Rimland D, Brown ST, Hoo G, Kim J, Lee PJ, Schnapp LM, Sharafkhaneh A, Justice AC, Crothers K. Increased Risk of Radiographic Emphysema in HIV Is Associated With Elevated Soluble CD14 and Nadir CD4. CHEST Journal 2014, 146: 1543-1553. PMID: 25080158, PMCID: PMC4251616, DOI: 10.1378/chest.14-0543.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsBiomarkersCD4 AntigensComorbidityConfidence IntervalsCross-Sectional StudiesFemaleHIV InfectionsHumansLipopolysaccharide ReceptorsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPrognosisPulmonary EmphysemaRadiographyReference ValuesRisk AssessmentSensitivity and SpecificitySeverity of Illness IndexSex FactorsStatistics, NonparametricConceptsIndependent risk factorSoluble CD14 levelsHIV infectionRadiographic emphysemaEmphysema severityCD14 levelsRisk factorsHIV-Associated Lung Emphysema (EXHALE) studyHigher soluble CD14 levelsNadir CD4 cell countMultivariable logistic regression modelElevated soluble CD14CD4 cell countCells/μLLower lung zonesRisk of HIVCross-sectional analysisLogistic regression modelsNadir CD4HIV RNALung involvementHIV severityD-dimerDiffuse involvementMultivariable analysis