Prevalence of many comorbidities is similar irrespective of the time since HIV diagnosis in persons ageing with HIV who have survived to age 65 years.

Objective

To compare the prevalence of comorbidity in persons with HIV ≥65 years of age based on the time from HIV diagnosis.

Design

Cross-sectional observational cohort study.

Methods

Data was collected from 540 participants in the CHANGE HIV (Correlates of Healthy Aging in Geriatric HIV) study, a longitudinal study of HIV in persons aged 65 years and older from seven primary and tertiary care centres in Canada between 2019 and 2026. We compared the baseline prevalence of comorbidities stratified by the cumulative time since known HIV diagnosis (<20 years, 20-30 years and >30 years) and controlled for demographic, HIV and lifestyle factors.

Results

The cohort was 90% male, median age 69 years, 76% white, median CD4 561 cells/mm3 and 92% with an undetectable viral load. They had a median of 3 (range 0-12) comorbid conditions. There was no difference in prevalence of coronary artery disease, dyslipidaemia, peripheral artery disease, stroke, chronic obstructive lung disease, asthma, arthritis, Parkinson's disease, HIV-associated neurocognitive dysfunction, chronic kidney disease, diabetes or liver disease based on time since HIV diagnosis. After accounting for confounders, longer time since HIV diagnosis was associated with higher prevalence of cancer, diabetes and peripheral neuropathy. Of the comorbidities only peripheral neuropathy, dyslipidaemia and Kaposi's sarcoma occurred at a younger age.

Conclusions

Prevalence of many comorbidities was not increased in those with longer time since HIV diagnosis. Lifestyle factors (smoking, substance use and diet) are important contributors to non-infectious comorbidities in this population, and increased prevalence of cancer reinforces the importance of preventative screening.