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
2018
Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial
Edelman EJ, Moore BA, Holt SR, Hansen N, Kyriakides TC, Virata M, Brown ST, Justice AC, Bryant KJ, Fiellin DA, Fiellin LE. Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial. AIDS And Behavior 2018, 23: 211-221. PMID: 30073637, PMCID: PMC6476298, DOI: 10.1007/s10461-018-2241-z.Peer-Reviewed Original ResearchConceptsHIV-positive patientsHeavy drinking daysVACS Index scoreXR-NTXART adherenceDrinking daysIndex scoreUndetectable HIV viral loadCD4 cell countExtended-release naltrexoneDouble-blind placeboHIV viral loadRandomized-controlled trialDrinking outcomesHIV biomarkersSecondary outcomesHIV outcomesPrimary outcomeViral loadAntiretroviral adherenceClinical trialsCell countAlcohol treatmentHIVPatients
2016
Baseline, Time-Updated, and Cumulative HIV Care Metrics for Predicting Acute Myocardial Infarction and All-Cause Mortality
Salinas JL, Rentsch C, Marconi VC, Tate J, Budoff M, Butt AA, Freiberg MS, Gibert CL, Goetz MB, Leaf D, Rodriguez-Barradas MC, Justice AC, Rimland D. Baseline, Time-Updated, and Cumulative HIV Care Metrics for Predicting Acute Myocardial Infarction and All-Cause Mortality. Clinical Infectious Diseases 2016, 63: 1423-1430. PMID: 27539575, PMCID: PMC5106607, DOI: 10.1093/cid/ciw564.Peer-Reviewed Original ResearchConceptsAcute myocardial infarctionIncident acute myocardial infarctionVeterans Aging Cohort StudyCombination antiretroviral therapyCardiovascular risk factorsHIV-1 RNAVACS IndexHazard ratioMyocardial infarctionRisk factorsMultivariable proportional hazards modelsVACS Index scoreLast clinic visitAging Cohort StudyHuman immunodeficiency virusProportional hazards modelCART initiationAntiretroviral therapyCause mortalityCD4 countClinic visitsCohort studyOrgan injuryPrimary outcomeImmunodeficiency virusRisk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men
Justice AC, McGinnis KA, Tate JP, Braithwaite RS, Bryant KJ, Cook RL, Edelman EJ, Fiellin LE, Freiberg MS, Gordon AJ, Kraemer KL, Marshall BD, Williams EC, Fiellin DA. Risk of mortality and physiologic injury evident with lower alcohol exposure among HIV infected compared with uninfected men. Drug And Alcohol Dependence 2016, 161: 95-103. PMID: 26861883, PMCID: PMC4792710, DOI: 10.1016/j.drugalcdep.2016.01.017.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyRisk of mortalityAUDIT-C scoresUninfected individualsPhysiologic injuryAlcohol exposureUndetectable HIV-1 RNACox proportional hazards modelAlcohol useVACS Index scoreHepatitis C infectionAging Cohort StudyHIV-1 RNAProportional hazards modelAlcohol consumption limitsLow alcohol exposureAlcohol-related harmRace/ethnicityAntiretroviral therapyC infectionUninfected menCohort studyHIV statusHazards modelIndex score
2015
Incarceration and health outcomes in HIV‐infected patients: The impact of substance use, primary care engagement, and antiretroviral adherence
Wang EA, McGinnis KA, Long JB, Akgün KM, Edelman EJ, Rimland D, Wang KH, Justice AC, Fiellin DA. Incarceration and health outcomes in HIV‐infected patients: The impact of substance use, primary care engagement, and antiretroviral adherence. American Journal On Addictions 2015, 24: 178-184. PMID: 25662297, PMCID: PMC4397180, DOI: 10.1111/ajad.12177.Peer-Reviewed Original ResearchConceptsVeterans Aging Cohort StudyHistory of incarcerationHIV disease outcomeVACS Index scorePrimary care engagementAntiretroviral adherenceCare engagementDisease outcomeIndex scoreDrug useHigher VACS Index scoresHealth of HIVAging Cohort StudyUnhealthy alcohol useViral RNA loadRecent drug useLow CD4Cohort studyRNA loadDrug treatmentHIVHealth outcomesMultivariate analysisMediation analysisPatients
2013
Sex Disparities in Overall Burden of Disease Among HIV-Infected Individuals in the Veterans Affairs Healthcare System
Blackstock OJ, Tate JP, Akgün KM, Crystal S, Duggal M, Edelman EJ, Gibert CL, Gordon KS, Rimland D, Rodriguez-Barradas MC, Wang EA, Fiellin DA, Justice AC. Sex Disparities in Overall Burden of Disease Among HIV-Infected Individuals in the Veterans Affairs Healthcare System. Journal Of General Internal Medicine 2013, 28: 577-582. PMID: 23807068, PMCID: PMC3695278, DOI: 10.1007/s11606-013-2346-z.Peer-Reviewed Original ResearchConceptsVeterans Affairs Healthcare SystemART initiationOverall burdenAntiretroviral therapyVeterans Aging Cohort Study Virtual CohortVACS Index scoreART-naïve HIVLower hemoglobin levelsHuman immunodeficiency virusBurden of diseaseHealthcare systemHIV biomarkersVACS IndexVACS-VCCause mortalityHIV careLiver dysfunctionART adherenceHemoglobin levelsImmunodeficiency virusHIV treatmentModifiable factorsPharmacy dataResultsComplete dataMultivariable regressionAssociation 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 strengthPredictive 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-statisticPhysiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans
Womack JA, Goulet JL, Gibert C, Brandt CA, Skanderson M, Gulanski B, Rimland D, Rodriguez-Barradas MC, Tate J, Yin MT, Justice AC, Team F. Physiologic Frailty and Fragility Fracture in HIV-Infected Male Veterans. Clinical Infectious Diseases 2013, 56: 1498-1504. PMID: 23378285, PMCID: PMC3634308, DOI: 10.1093/cid/cit056.Peer-Reviewed Original ResearchConceptsHuman immunodeficiency virusVACS Index scoreFragility fracturesPhysiologic frailtyVACS IndexMale veteransInhibitor useFracture riskRisk factorsVeterans Aging Cohort Study (VACS) IndexIndex scoreFragility fracture risk factorsICD-9-CM codesProtease inhibitor useFracture risk factorsMarkers of inflammationBody mass indexUpper arm fracturesAlcohol-related diagnosesCox regression modelFirst fragility fractureCause mortalityHIV RNAHemoglobin levelsMass indexRisk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans
Akgün KM, Gordon K, Pisani M, Fried T, McGinnis KA, Tate JP, Butt AA, Gibert CL, Huang L, Rodriguez-Barradas MC, Rimland D, Justice AC, Crothers K. Risk Factors for Hospitalization and Medical Intensive Care Unit (MICU) Admission Among HIV-Infected Veterans. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2013, 62: 52-59. PMID: 23111572, PMCID: PMC4182723, DOI: 10.1097/qai.0b013e318278f3fa.Peer-Reviewed Original ResearchConceptsVACS Index scoreMedical intensive care unit admissionIntensive care unit admissionVeterans Aging Cohort StudyCare unit admissionMICU admissionIndex scoreRisk factorsHazardous alcohol useVACS IndexUnit admissionCurrent smokingChronic obstructive pulmonary diseaseAlcohol useNon-AIDS diseasesVA administrative databasesMultivariable Cox regressionSurvival of HIVObstructive pulmonary diseaseAging Cohort StudyElectronic medical recordsAntiretroviral therapyCause mortalityPrior AIDSPrior cancer