The effects of age on associations between markers of HIV progression and markers of metabolic function including albumin, haemoglobin and lipid concentrations

M. Samuel*, S. Jose, A. Winston, M. Nelson, M. Johnson, D. Chadwick, M. Fisher, C. Leen, M. Gompels, R. Gilson, F. A. Post, P. Hay, C. A. Sabin, Jonathan Ainsworth, J. Anderson, Abdel Babiker, David Chadwick, Valerie Delpech, Martin Fisher, Brian GazzardRichard Gilson, Mark Gompels, Phillip Hay, Margaret Johnson, Stephen Kegg, Clifford Leen, Mark Nelson, Chloe Orkin, Adrian Palfreeman, Deenan Pillay, Memory Sachikonye, Achim Schwenk, John Walsh, Teresa Hill, Susie Huntington, Sophie Jose, Andrew Phillips, Caroline Sabin, Alicia Thornton, David Dunn, Adam Glabay, C. Orkin, N. Garrett, J. Lynch, J. Hand, C. de Souza, M. Fisher, N. Perry, S. Tilbury, D. Churchill, B. Gazzard, M. Nelson, M. Waxman, D. Asboe, S. Mandalia, S. Munshi, H. Korat, M. Poulton, C. Taylor, Z. Gleisner, L. Campbell, R. Gilson, N. Brima, I. Williams, A. Schwenk, J. Ainsworth, C. Wood, S. Miller, M. Johnson, M. Youle, F. Lampe, C. Smith, H. Grabowska, C. Chaloner, D. Puradiredja, J. Walsh, J. Weber, F. Ramzan, N. Mackie, A. Winston, C. Leen, A. Wilson, M. Gompels, S. Allan, A. Palfreeman, A. Moore, D. Chadwick, K. Wakeman, F. Martin, S. Douglas, P. Hay, M. Dhillon

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Objectives: We investigated whether age modified associations between markers of HIV progression, CD4 T lymphocyte count and HIV RNA viral load (VL), and the following markers of metabolic function: albumin, haemoglobin, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC). Methods: A retrospective analysis of data from the United Kingdom Collaborative HIV Cohort was carried out. Analyses were limited to antiretroviral-naïve subjects to focus on the impact of HIV disease itself. A total of 16670 subjects were included in the analysis. Multilevel linear regression models assessed associations between CD4 count/VL and each of the outcomes. Statistical tests for interactions assessed whether associations differed among age groups. Results: After adjustment for gender and ethnicity, there was evidence that lower CD4 count and higher VL were associated with lower TC, LDL-C, haemoglobin and albumin concentrations but higher triglyceride concentrations. Age modified associations between CD4 count and albumin (P<0.001) and haemoglobin (P=0.001), but not between CD4 count and HDL-C, LDL-C and TC, or VL and any outcome. Among participants aged <30, 30-50 and >50 years, a 50 cells/μL lower CD4 count correlated with a 2.4 [95% confidence interval (CI) 1.7-3.0], 3.6 (95% CI 3.2-4.0) and 5.1 (95% CI 4.0-6.1) g/L lower haemoglobin concentration and a 0.09 (95% CI 0.07-0.11), 0.12 (95% CI 0.11-0.13) and 0.16 (95% CI 0.13-0.19) g/L lower albumin concentration, respectively. Conclusions: We present evidence that age modifies associations between CD4 count and plasma albumin and haemoglobin levels. A given reduction in CD4 count was associated with a greater reduction in haemoglobin and albumin concentrations among older people living with HIV. These findings increase our understanding of how the metabolic impact of HIV is influenced by age.

Original languageEnglish
Pages (from-to)311-316
Number of pages6
JournalHIV Medicine
Volume15
Issue number5
DOIs
Publication statusPublished - 1 Apr 2014

Keywords

  • Ageing
  • Albumin
  • HIV
  • Haemoglobin
  • Lipid metabolism

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