935 results on '"Erlandson, Kristine M."'
Search Results
2. Association Between Metformin Use and Cognitive and Physical Function in Persons with HIV and Diabetes
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Masters, Mary Clare, Granche, Janeway, Yang, Jingyan, Overton, Edgar T, Letendre, Scott, Koletar, Susan L, Rubin, Leah H, Brown, Todd T, Tassiopoulos, Katherine, Erlandson, Kristine M, and Palella, Frank
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Biomedical and Clinical Sciences ,Clinical Sciences ,HIV/AIDS ,Infectious Diseases ,Rehabilitation ,Diabetes ,Aging ,Sexually Transmitted Infections ,Humans ,Aged ,Aged ,80 and over ,Metformin ,Frailty ,Cross-Sectional Studies ,HIV Infections ,Diabetes Mellitus ,Cognition ,metformin ,HIV ,frailty ,physical function ,aging ,Virology ,Clinical sciences - Abstract
Older persons with HIV (PWH) experience high rates of cognitive impairment and frailty, and accelerated decline in physical function compared with the general population. Metformin use has been associated with beneficial effects on cognitive and physical function among older adults without HIV. The relationship between metformin use on these outcomes in PWH has not been evaluated. AIDS Clinical Trials Group (ACTG) A5322 is an observational cohort study of older PWH with annual assessments for cognition and frailty, including measures of physical function (e.g., gait speed and grip strength). Participants with diabetes who were prescribed antihyperglycemic medications were included in this analysis to evaluate the association between metformin and functional outcomes. Cross-sectional, longitudinal, and time-to-event models were used to evaluate the relationship between metformin exposure with cognitive, physical function, and frailty outcomes. Ninety-eight PWH met inclusion criteria and were included in at least one model. No significant associations between metformin use, frailty, physical, or cognitive function were noted in unadjusted or adjusted cross-sectional, longitudinal, or time-to-event models (p > .1 for all models). This study is the first to examine the association between metformin use on functional outcomes among older PWH. Although it did not ascertain significant associations between metformin use and functional outcomes, our small sample size, restriction to persons with diabetes, and lack of randomization to metformin therapy were limitations. Larger randomized studies are needed to determine whether metformin use has beneficial effects on cognitive or physical function in PWH. Clinical Trial Registration numbers: 02570672, 04221750, 00620191, and 03733132.
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- 2023
3. Researching COVID to enhance recovery (RECOVER) adult study protocol: Rationale, objectives, and design
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Horwitz, Leora I, Thaweethai, Tanayott, Brosnahan, Shari B, Cicek, Mine S, Fitzgerald, Megan L, Goldman, Jason D, Hess, Rachel, Hodder, SL, Jacoby, Vanessa L, Jordan, Michael R, Krishnan, Jerry A, Laiyemo, Adeyinka O, Metz, Torri D, Nichols, Lauren, Patzer, Rachel E, Sekar, Anisha, Singer, Nora G, Stiles, Lauren E, Taylor, Barbara S, Ahmed, Shifa, Algren, Heather A, Anglin, Khamal, Aponte-Soto, Lisa, Ashktorab, Hassan, Bassett, Ingrid V, Bedi, Brahmchetna, Bhadelia, Nahid, Bime, Christian, Bind, Marie-Abele C, Black, Lora J, Blomkalns, Andra L, Brim, Hassan, Castro, Mario, Chan, James, Charney, Alexander W, Chen, Benjamin K, Chen, Li Qing, Chen, Peter, Chestek, David, Chibnik, Lori B, Chow, Dominic C, Chu, Helen Y, Clifton, Rebecca G, Collins, Shelby, Costantine, Maged M, Cribbs, Sushma K, Deeks, Steven G, Dickinson, John D, Donohue, Sarah E, Durstenfeld, Matthew S, Emery, Ivette F, Erlandson, Kristine M, Facelli, Julio C, Farah-Abraham, Rachael, Finn, Aloke V, Fischer, Melinda S, Flaherman, Valerie J, Fleurimont, Judes, Fonseca, Vivian, Gallagher, Emily J, Gander, Jennifer C, Gennaro, Maria Laura, Gibson, Kelly S, Go, Minjoung, Goodman, Steven N, Granger, Joey P, Greenway, Frank L, Hafner, John W, Han, Jenny E, Harkins, Michelle S, Hauser, Kristine SP, Heath, James R, Hernandez, Carla R, Ho, On, Hoffman, Matthew K, Hoover, Susan E, Horowitz, Carol R, Hsu, Harvey, Hsue, Priscilla Y, Hughes, Brenna L, Jagannathan, Prasanna, James, Judith A, John, Janice, Jolley, Sarah, Judd, SE, Juskowich, Joy J, Kanjilal, Diane G, Karlson, Elizabeth W, Katz, Stuart D, Kelly, J Daniel, Kelly, Sara W, Kim, Arthur Y, Kirwan, John P, Knox, Kenneth S, Kumar, Andre, Lamendola-Essel, Michelle F, Lanca, Margaret, Lee-lannotti, Joyce K, Lefebvre, R Craig, and Levy, Bruce D
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Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Clinical Research ,Emerging Infectious Diseases ,Infectious Diseases ,Infection ,Good Health and Well Being - Abstract
Abstract: Importance: SARS-CoV-2 infection can result in ongoing, relapsing, or new symptoms or other health effects after the acute phase of infection; termed post-acute sequelae of SARS-CoV-2 infection (PASC), or long COVID. The characteristics, prevalence, trajectory and mechanisms of PASC are ill-defined. The objectives of the Researching COVID to Enhance Recovery (RECOVER) Multi-site Observational Study of PASC in Adults (RECOVER-Adult) are to: (1) characterize PASC prevalence; (2) characterize the symptoms, organ dysfunction, natural history, and distinct phenotypes of PASC; (3) identify demographic, social and clinical risk factors for PASC onset and recovery; and (4) define the biological mechanisms underlying PASC pathogenesis. Methods: RECOVER-Adult is a combined prospective/retrospective cohort currently planned to enroll 14,880 adults aged ≥18 years. Eligible participants either must meet WHO criteria for suspected, probable, or confirmed infection; or must have evidence of no prior infection. Recruitment occurs at 86 sites in 33 U.S. states, Washington, DC and Puerto Rico, via facility– and community-based outreach. Participants complete quarterly questionnaires about symptoms, social determinants, vaccination status, and interim SARS-CoV-2 infections. In addition, participants contribute biospecimens and undergo physical and laboratory examinations at approximately 0, 90 and 180 days from infection or negative test date, and yearly thereafter. Some participants undergo additional testing based on specific criteria or random sampling. Patient representatives provide input on all study processes. The primary study outcome is onset of PASC, measured by signs and symptoms. A paradigm for identifying PASC cases will be defined and updated using supervised and unsupervised learning approaches with cross– validation. Logistic regression and proportional hazards regression will be conducted to investigate associations between risk factors, onset, and resolution of PASC symptoms. Discussion: RECOVER-Adult is the first national, prospective, longitudinal cohort of PASC among US adults. Results of this study are intended to inform public health, spur clinical trials, and expand treatment options.
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- 2023
4. Cytomegalovirus Immunoglobulin G (IgG) Titer and Coronary Artery Disease in People With Human Immunodeficiency Virus (HIV)
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Schnittman, Samuel R, Lu, Michael T, Mayrhofer, Thomas, Burdo, Tricia H, Fitch, Kathleen V, McCallum, Sara, Fulda, Evelynne S, Zanni, Markella V, Foldyna, Borek, Malvestutto, Carlos, Fichtenbaum, Carl J, Aberg, Judith A, Bloomfield, Gerald S, Overton, Edgar T, Currier, Judith, Tebas, Pablo, Sha, Beverly E, Ribaudo, Heather J, Flynn, Jacqueline M, Douglas, Pamela S, Erlandson, Kristine M, and Grinspoon, Steven K
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Medical Microbiology ,Biomedical and Clinical Sciences ,Immunology ,Prevention ,Atherosclerosis ,Infectious Diseases ,HIV/AIDS ,Cardiovascular ,Patient Safety ,Clinical Research ,Clinical Trials and Supportive Activities ,Heart Disease - Coronary Heart Disease ,Heart Disease ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Inflammatory and immune system ,Infection ,Good Health and Well Being ,Male ,Humans ,Middle Aged ,Female ,Cytomegalovirus ,Coronary Artery Disease ,Immunoglobulin G ,HIV ,Cardiovascular Diseases ,Cytomegalovirus Infections ,HIV Infections ,Biomarkers ,human immunodeficiency virus ,cytomegalovirus ,cardiovascular disease ,coronary artery disease ,inflammation ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundCytomegalovirus (CMV) infection is thought to result in increased immune activation in people with human immunodeficiency virus (HIV, PWH). Although some data have linked asymptomatic CMV infection to cardiovascular disease among PWH, it remains unknown whether CMV is associated with increased or high-risk coronary plaque.MethodsThe Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) enrolled PWH aged 40-75 years on stable antiretroviral therapy (ART) with low-to-moderate atherosclerotic cardiovascular disease (ASCVD) risk. Among a subset of US REPRIEVE participants, coronary plaque was assessed by coronary computed tomography angiography. Here, we assessed the relationship between CMV immunoglobulin G (IgG) titer and (1) levels of immune activation, (2) inflammatory biomarkers, and (3) coronary plaque phenotypes at study entry.ResultsOf 672 participants, mean age was 51 years, 83% were men, median ASCVD risk score was 4.5%, and 66% had current CD4+ T-cell count ≥500 cells/mm3. Higher CMV IgG quartile group was associated with older age and lower current and nadir CD4+ T-cell counts. CMV IgG titer was associated with specific inflammatory biomarkers (sCD163, MCP-1, interleukin [IL]-6, hsCRP) in univariate analysis, but not after controlling for HIV-specific factors. In contrast, CMV IgG titer was not associated with coronary artery disease indexes, including presence of plaque, coronary artery calcium (CAC) score >0, vulnerable plaque presence, or Leaman score >5.ConclusionsNo meaningful association was seen between CMV IgG titer and coronary artery disease indexes among ART-treated PWH at study enrollment. Longitudinal assessments in REPRIEVE will determine the relationship of CMV IgG titer to plaque progression and cardiovascular events.Clinical trials registrationNCT02344290.
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- 2023
5. Sex Differences in Subclinical Atherosclerosis and Systemic Immune Activation/Inflammation Among People With Human Immunodeficiency Virus in the United States
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Zanni, Markella V, Foldyna, Borek, McCallum, Sara, Burdo, Tricia H, Looby, Sara E, Fitch, Kathleen V, Fulda, Evelynne S, Autissier, Patrick, Bloomfield, Gerald S, Malvestutto, Carlos D, Fichtenbaum, Carl J, Overton, Edgar T, Aberg, Judith A, Erlandson, Kristine M, Campbell, Thomas B, Ellsworth, Grant B, Sheth, Anandi N, Taiwo, Babafemi, Currier, Judith S, Hoffmann, Udo, Lu, Michael T, Douglas, Pamela S, Ribaudo, Heather J, and Grinspoon, Steven K
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Biomedical and Clinical Sciences ,Immunology ,Infectious Diseases ,Prevention ,Atherosclerosis ,Heart Disease ,Cardiovascular ,Clinical Research ,Clinical Trials and Supportive Activities ,Good Health and Well Being ,Humans ,Female ,Male ,United States ,HIV ,Sex Characteristics ,1-Alkyl-2-acetylglycerophosphocholine Esterase ,Plaque ,Atherosclerotic ,Risk Factors ,Inflammation ,Biomarkers ,Coronary Artery Disease ,coronary atherosclerosis ,inflammation ,women ,reproductive aging ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundAmong people with HIV (PWH), sex differences in presentations of atherosclerotic cardiovascular disease (ASCVD) may be influenced by differences in coronary plaque parameters, immune/inflammatory biomarkers, or relationships therein.MethodsREPRIEVE, a primary ASCVD prevention trial, enrolled antiretroviral therapy (ART)-treated PWH. At entry, a subset of US participants underwent coronary computed tomography angiography (CTA) and immune phenotyping (n = 755 CTA; n = 725 CTA + immune). We characterized sex differences in coronary plaque and immune/inflammatory biomarkers and compared immune-plaque relationships by sex. Unless noted otherwise, analyses adjust for ASCVD risk score.ResultsThe primary analysis cohort included 631 males and 124 females. ASCVD risk was higher among males (median: 4.9% vs 2.1%), while obesity rates were higher among females (48% vs 21%). Prevalence of any plaque and of plaque with either ≥1 visible noncalcified portion or vulnerable features (NC/V-P) was lower among females overall and controlling for relevant risk factors (RR [95% CI] for any plaque: .67 [.50, .92]; RR for NC/V-P: .71 [.51, 1.00] [adjusted for ASCVD risk score and body mass index]). Females showed higher levels of IL-6, hs-CRP, and D-dimer and lower levels of Lp-PLA2 (P < .001 for all). Higher levels of Lp-PLA2, MCP-1, and oxLDL were associated with higher plaque (P < .02) and NC/V-P prevalence, with no differences by sex. Among females but not males, D-dimer was associated with higher prevalence of NC/V-P (interaction P = .055).ConclusionsAmong US PWH, females had a lower prevalence of plaque and NC/V-P, as well as differences in key immune/inflammatory biomarkers. Immune-plaque relationships differed by sex for D-dimer but not other tested parameters. Clinical Trial Registration. ClinicalTrials.gov; identifier: NCT0234429 (date of initial registration: 22 January 2015).
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- 2023
6. Cannabis Use Is Associated With Decreased Antiretroviral Therapy Adherence Among Older Adults With HIV
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Manuzak, Jennifer A, Granche, Janeway, Tassiopoulos, Katherine, Rower, Joseph E, Knox, Justin R, Williams, Dionna W, Ellis, Ronald J, Goodkin, Karl, Sharma, Anjali, Erlandson, Kristine M, and Team, for the AIDS Clinical Trials Group A5322 Study
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Biomedical and Clinical Sciences ,Clinical Sciences ,HIV/AIDS ,Clinical Research ,Behavioral and Social Science ,Cannabinoid Research ,Infectious Diseases ,Sexually Transmitted Infections ,7.1 Individual care needs ,Good Health and Well Being ,adherence ,aging ,antiretroviral therapy ,cannabis ,HIV ,AIDS Clinical Trials Group (ACTG) A5322 Study Team ,Clinical sciences ,Medical microbiology - Abstract
BackgroundConflicting evidence exists on the impact of cannabis use on antiretroviral therapy (ART) adherence among people with human immunodeficiency virus (PWH). We leveraged data collected among older PWH to characterize longitudinal associations between cannabis use and ART adherence.MethodsAIDS Clinical Trials Group (ACTG) A5322 study participants were categorized as
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- 2023
7. Current Challenges and Solutions for Clinical Management and Care of People with HIV: Findings from the 12th Annual International HIV and Aging Workshop
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Yu, Xiaoying, Lobo, Judith D, Sundermann, Erin, Baker, Darren J, Tracy, Russell P, Kuchel, George A, Stephenson, Kathryn E, Letendre, Scott L, Brew, Bruce, Cysique, Lucette A, Dale, Sannisha K, Wallen, Chelsie, Kunisaki, Ken M, Guaraldi, Giovanni, Milic, Jovana, Winston, Alan, Moore, David J, Margolick, Joseph B, and Erlandson, Kristine M
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Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,Aging ,HIV/AIDS ,Infection ,Good Health and Well Being ,Humans ,Aged ,HIV Infections ,Pandemics ,Quality of Life ,COVID-19 ,HIV ,aging ,biological mechanism ,quality of life ,delivery of care ,Virology ,Clinical sciences - Abstract
People with HIV on combination antiretroviral therapy (ART) have longer life expectancy and are increasingly experiencing age-related comorbidities. Thus, aging with HIV has become a central issue in clinical care and research, which has been particularly challenging with the intersection of the ongoing coronavirus (COVID)-19 pandemic. Since 2009, the International Workshop on HIV and Aging has served as a multidisciplinary platform to share research findings from cross-disciplinary fields along with community advocates to address critical issues in HIV and aging. In this article, we summarize the key oral presentations from the 12th Annual International Workshop on HIV and Aging, held virtually on September 23rd and 24th, 2021. The topics ranged from basic science research on biological mechanisms of aging to quality of life and delivery of care under the COVID-19 pandemic. This workshop enriched our understanding of HIV and aging under the COVID-19 pandemic, identified challenges and opportunities to combat the impact of COVID-19 on HIV communities, and also provided updated research and future directions of the field to move HIV and aging research forward, with the ultimate goal of successful aging for older people with HIV.
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- 2023
8. Factors Associated With Systemic Immune Activation Indices in a Global Primary Cardiovascular Disease Prevention Cohort of People With Human Immunodeficiency Virus on Antiretroviral Therapy
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Looby, Sara E, Kantor, Amy, Burdo, Tricia H, Currier, Judith S, Fichtenbaum, Carl J, Overton, Edgar T, Aberg, Judith A, Malvestutto, Carlos D, Bloomfield, Gerald S, Erlandson, Kristine M, Cespedes, Michelle, Kallas, Esper G, Masiá, Mar, Thornton, Alice C, Smith, Mandy D, Flynn, Jacqueline M, Kileel, Emma M, Fulda, Evelynne, Fitch, Kathleen V, Lu, Michael T, Douglas, Pamela S, Grinspoon, Steven K, Ribaudo, Heather J, and Zanni, Markella V
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Biomedical and Clinical Sciences ,Immunology ,Heart Disease ,Health Disparities ,Infectious Diseases ,Prevention ,Sexually Transmitted Infections ,Clinical Research ,Minority Health ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Atherosclerosis ,Cardiovascular ,6.1 Pharmaceuticals ,Good Health and Well Being ,Biomarkers ,Cardiovascular Diseases ,Female ,HIV ,HIV Infections ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Integrases ,Lipopolysaccharide Receptors ,Lipoproteins ,LDL ,Male ,Middle Aged ,Nucleosides ,Reverse Transcriptase Inhibitors ,cardiovascular disease risk ,immune activation markers ,women ,reproductive aging ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundAmong antiretroviral therapy (ART)-treated people with human immunodeficiency virus (PWH), persistent systemic immune activation contributes to atherogenesis atherosclerotic, cardiovascular disease (CVD) events, and mortality. Factors associated with key immune activation indices have not previously been characterized among a global primary CVD prevention cohort of PWH.MethodsLeveraging baseline Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) data, we evaluated factors associated with soluble CD14 (sCD14) and oxidized low-density lipoprotein (oxLDL).ResultsThe primary analysis cohort included 4907 participants from 5 global-burden-of-disease regions (38% female, 48% Black, median age 50 years). In fully adjusted models for sCD14, female sex and White race (among those in high-income regions) were associated with higher sCD14 levels, while higher body mass index (BMI) and current use of nucleoside reverse transcriptase inhibitor + integrase strand transfer inhibitor ART were associated with lower sCD14 levels. In fully adjusted models for oxLDL, male sex, residence in high-income regions, White race (among those in high-income regions), and higher BMI were associated with higher oxLDL levels. In a subanalysis cohort of 1396 women with HIV, increased reproductive age was associated with higher sCD14 levels but not with higher oxLDL levels.ConclusionsFactors associated with sCD14 and oxLDL, 2 key indices of immune-mediated CVD risk, differ. Future studies will elucidate ways in which medications (eg, statins) and behavioral modifications influence sCD14 and oxLDL and the extent to which dampening of these markers mediates CVD-protective effects.Clinical trials registrationNCT0234429.
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- 2022
9. Poorer Muscle Quality and Quantity With ART Initiation Is Associated With Greater Inflammation and Immune Activation
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Kousari, Arianna, Moser, Carlee, Olefsky, Maxine, Brown, Todd T, Currier, Judith S, McComsey, Grace A, Scherzinger, Ann, Stein, James H, Lake, Jordan E, and Erlandson, Kristine M
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Clinical Research ,Anti-HIV Agents ,Antiretroviral Therapy ,Highly Active ,Biomarkers ,C-Reactive Protein ,HIV Infections ,HIV Protease Inhibitors ,Humans ,Immune System ,Inflammation ,Interleukin-6 ,Lipopolysaccharide Receptors ,Muscle ,Skeletal ,Treatment Outcome ,inflammation ,immune activation ,muscle ,HIV ,antiretroviral therapy ,ectopic fat ,Clinical Sciences ,Public Health and Health Services ,Virology - Abstract
BackgroundWe have previously shown that the initiation of antiretroviral therapy (ART) is associated with a decrease in skeletal muscle density (greater fat accumulation), suggesting that gains in lean body mass seen in many ART studies may reflect gains in low quality, fatty muscle. Here, we explore whether skeletal muscle density and area are associated with markers of inflammation and immune activation.MethodsART-naïve people with HIV were randomized to raltegravir or ritonavir-boosted atazanavir or darunavir, each with tenofovir disoproxil fumarate/emtricitabine. Abdominal computed tomography scans from baseline and week 96 were reanalyzed for psoas density and area and correlations explored with inflammation [interleukin-6 (IL-6) and high-sensitivity C-reactive protein] and immune activation [soluble CD14 (sCD14), soluble CD163 (sCD163), and %CD38+HLADR+ on CD4+ or CD8+ T cells].ResultsTwo hundred twenty-two participants had available inflammation/immune activation markers and paired computed tomography scans. At baseline, lower psoas density (greater fat) correlated with higher IL-6 (r = -0.26, P < 0.001) and sCD163 (r -0.15, P = 0.03) and lower lean psoas area correlated with higher IL-6, high-sensitivity C-reactive protein, sCD14, sCD163, and %CD38+HLADR+ on CD4+ T cells (r = -0.30-0.13; all P ≤ 0.05). From baseline to week 96, greater percent decrease in total psoas density (more fat) correlated with greater increase in IL-6 (r = -0.14; P = 0.04); greater % decrease in lean psoas area correlated greater increases in IL-6, sCD14, sCD163, and %CD38+HLADR+ on CD8+ T cells (r = -0.15 to -0.18; all P < 0.04).ConclusionsGreater fat infiltration within the psoas muscle (lower density) and greater loss in lean psoas muscle area were associated with higher inflammation and immune activation, which may portend important effects on muscle function and cardiometabolic risk.
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- 2021
10. Current Considerations for Clinical Management and Care of People with HIV: Findings from the 11th Annual International HIV and Aging Workshop.
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Kamkwalala, Asante R, Garg, Ankita, Roy, Upal, Matthews, Avery, Castillo-Mancilla, Jose, Lake, Jordan E, Sebastiani, Giada, Yin, Michael, Brown, Todd T, Kamer, Angela R, Jabs, Douglas A, Ellis, Ronald J, Boffito, Marta, Greene, Meredith, Schmalzle, Sarah, Siegler, Eugenia, Erlandson, Kristine M, and Moore, David J
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HIV ,aging ,antiretroviral therapy ,clinical outcomes ,neuroscience ,Aging ,HIV Infections ,Humans ,Quality of Life ,Mental Health ,HIV/AIDS ,Infectious Diseases ,Virology ,Clinical Sciences - Abstract
The number of people with HIV (PWH) aged 50 years or older continues to steadily increase. The convergence of age- and HIV-related complications in these individuals presents a challenge for both patients and clinicians alike. New findings continue to emerge, as numerous researchers evaluate the combined impact of these two factors on quality of life, physiological systems, and mental health in PWH. Since its first occurrence in 2009, the International Workshop on HIV and Aging has served as a multidisciplinary meeting to share basic biomedical data, clinical trial results, treatment strategies, and epidemiological recommendations, toward better understanding and outcomes among like-minded scientific professionals. In this article, we share a selection of key findings presented in plenary talks at the 11th Annual International Workshop on HIV and Aging, held virtually from September 30, 2020 to October 2, 2020. We will also address the future directions of HIV and aging research, to further assess how the aging process intersects with chronic HIV.
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- 2021
11. Obesity among women with HIV
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Millman, Nina, Koethe, John R., and Erlandson, Kristine M.
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- 2023
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12. Baseline Neurocognitive Impairment (NCI) Is Associated With Incident Frailty but Baseline Frailty Does Not Predict Incident NCI in Older Persons With Human Immunodeficiency Virus (HIV)
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Masters, Mary Clare, Perez, Jeremiah, Wu, Kunling, Ellis, Ronald J, Goodkin, Karl, Koletar, Susan L, Andrade, Adriana, Yang, Jingyan, Brown, Todd T, Palella, Frank J, Sacktor, Ned, Tassiopoulos, Katherine, and Erlandson, Kristine M
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Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Infectious Diseases ,Brain Disorders ,Clinical Research ,HIV/AIDS ,Aging ,Aged ,Aged ,80 and over ,Cohort Studies ,Frailty ,HIV ,HIV Infections ,Humans ,Middle Aged ,Odds Ratio ,frailty ,neurocognitive impairment ,aging ,HIV and aging ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundNeurocognitive impairment (NCI) and frailty are more prevalent among persons with HIV (PWH) compared to those without HIV. Frailty and NCI often overlap with one another. Whether frailty precedes declines in neurocognitive function among PWH or vice versa has not been well-established.SettingAIDS Clinical Trials Group (ACTG) A5322 is an observational cohort study of older PWH. Participants undergo annual assessments for NCI and frailty.MethodsACTG A5322 participants who developed NCI as indexed by tests of impaired executive functioning and processing speed during the first 3 years were compared to persons who maintained normal cognitive function; those who demonstrated resolution of NCI were compared to those who had persistent NCI. Participants were similarly compared by frailty trajectory. We fit multinomial logistic regression models to assess associations between baseline covariates (including NCI) and frailty, and associations between baseline covariates (including frailty) and NCI.Results929 participants were included with a median age of 51 years (IQR 46-56). At study entry, 16% had NCI and 6% were frail. Over 3 years, 6% of participants developed NCI; 5% developed frailty. NCI was associated with development of frailty (odds ratio [OR]=2.06; 95% confidence interval [CI]=0.94, 4.48; p=0.07). Further adjustment for confounding strengthened this association (OR=2.79; 95% CI=1.21, 6.43; p=0.02). Baseline frailty however was not associated with NCI development.ConclusionsNCI was associated with increased risk of frailty, but frailty was not associated with development of NCI. These findings suggest that the presence of NCI in PWH should prompt monitoring for the development of frailty and interventions to prevent frailty in this population.
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- 2021
13. Plasma Citrate and Succinate Are Associated With Neurocognitive Impairment in Older People With HIV
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Hileman, Corrilynn O, Kalayjian, Robert C, Azzam, Sausan, Schlatzer, Daniela, Wu, Kunling, Tassiopoulos, Katherine, Bedimo, Roger, Ellis, Ronald J, Erlandson, Kristine M, Kallianpur, Asha, Koletar, Susan L, Landay, Alan L, Palella, Frank J, Taiwo, Babafemi, Pallaki, Muralidhar, and Hoppel, Charles L
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Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,Clinical Research ,Neurosciences ,Adult ,Aged ,Citric Acid ,Cross-Sectional Studies ,HIV Infections ,Humans ,Middle Aged ,Prospective Studies ,Succinic Acid ,citrate ,succinate ,tricarboxylic acid cycle ,neurocognitive impairment ,human immunodeficiency virus ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundNeurocognitive impairment (NCI) is associated with monocyte activation in people with HIV (PWH). Activated monocytes increase glycolysis, reduce oxidative phosphorylation, and accumulate citrate and succinate, tricarboxylic acid (TCA) cycle metabolites that promote inflammation-this metabolic shift may contribute to NCI and slowed gait speed in PWH.MethodsPlasma citrate and succinate were assayed by liquid chromatography-mass spectrometry from 957 participants upon entry to a multicenter, prospective cohort of older PWH. Logistic, linear, and mixed-effects linear regression models were used to examine associations between entry/baseline TCA cycle metabolites and cross-sectional and longitudinal NCI, neuropsychological test scores (NPZ-4), and gait speed.ResultsMedian age was 51 (range 40-78) years. Each 1 standard deviation (SD) citrate increment was associated with 1.18 higher odds of prevalent NCI at baseline (P = .03), 0.07 SD lower time-updated NPZ-4 score (P = .01), and 0.02 m/s slower time-updated gait speed (P < .0001). Age accentuated these effects. In the oldest age-quartile, higher citrate was associated with 1.64 higher odds of prevalent NCI, 0.17 SD lower NPZ-4, and 0.04 m/s slower gait speed (P ≤ .01 for each). Similar associations were apparent with succinate in the oldest age-quintile, but not with gait speed. In participants without NCI at entry, higher citrate predicted a faster rate of neurocognitive decline.ConclusionsHigher plasma citrate and succinate are associated with worse cross-sectional and longitudinal measures of neurocognitive function and gait speed that are age-dependent, supporting the importance of altered bioenergetic metabolism in the pathogenesis of NCI in older PWH.
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- 2021
14. Self-Reported Cannabis Use and Markers of Inflammation in Men Who Have Sex With Men With and Without HIV
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Krsak, Martin, Wada, Nikolas I, Plankey, Michael W, Kinney, Gregory L, Epeldegui, Marta, Okafor, Chukwuemeka N, Friedman, Mackey Reuel, Palella, Frank J, and Erlandson, Kristine M
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Biomedical and Clinical Sciences ,Clinical Sciences ,Drug Abuse (NIDA only) ,HIV/AIDS ,Clinical Research ,Substance Misuse ,Prevention ,Infectious Diseases ,Aetiology ,2.1 Biological and endogenous factors ,Good Health and Well Being ,Biomarkers ,Cannabis ,Cohort Studies ,HIV Infections ,Homosexuality ,Male ,Humans ,Inflammation ,Male ,Prospective Studies ,Self Report ,Sexual and Gender Minorities ,HIV ,inflammation ,CBD ,THC ,cannabis ,inflammatory biomarkers ,Clinical sciences ,Pharmacology and pharmaceutical sciences ,Biological psychology - Abstract
Background: Chronic inflammation contributes to aging and organ dysfunction in the general population, and is a particularly important determinant of morbidity and mortality among people with HIV (PWH). The effect of cannabis use on chronic inflammation is not well understood among PWH, who use cannabis more frequently than the general population. Materials and Methods: We evaluated participants in the Multicenter AIDS Cohort Study (MACS) beginning in 2004 with available data on cannabis use and inflammatory biomarkers. Associations of current cannabis use with plasma concentrations of inflammatory markers were adjusted for hepatitis C, tobacco smoking, and comorbidities. Markers were analyzed individually and in exploratory factor analysis (EFA). Results: We included 1352 men within the MACS. Twenty-seven percent of HIV-negative men, 41% of HIV viremic men, and 35% of virologically suppressed men reported cannabis use at baseline. Among cannabis users, 20-25% in all groups defined by HIV serostatus were daily users, and the same proportion reported weekly use. The remaining ∼50% of users in all groups reported monthly or less frequent use. Four biomarker groupings were identified by EFA: Factor 1: immune activation markers; Factor 2: proinflammatory cytokines; Factor 3: Th1- and Th2-promoting cytokines; and Factor 4: inflammatory chemokines. In EFA, daily users had 30% higher levels of Factor 2 biomarkers than nonusers (p=0.03); this was the only statistically significant difference by cannabis use status. Among individual markers, concentrations of IL-1β, IL-2, IL-6, and IL-8 (Factor 2); IL-10 (Factor 3); and BAFF (Factor 1) were higher (p
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- 2021
15. Antiretroviral Therapy Initiation Is Associated With Decreased Visceral and Subcutaneous Adipose Tissue Density in People Living With Human Immunodeficiency Virus
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Debroy, Paula, Lake, Jordan E, Moser, Carlee, Olefsky, Maxine, Erlandson, Kristine M, Scherzinger, Ann, Stein, James H, Currier, Judith S, Brown, Todd T, and McComsey, Grace A
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HIV/AIDS ,Prevention ,Infectious Diseases ,Clinical Research ,Clinical Trials and Supportive Activities ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Adult ,Anti-HIV Agents ,Female ,HIV ,HIV Infections ,Humans ,Male ,Prospective Studies ,Subcutaneous Fat ,fat density ,inflammatory biomarkers ,antiretroviral therapy ,fat gain ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
BackgroundAdipose tissue (AT) alterations are common in people living with human immunodeficiency virus (PLWH). Decreases in AT density suggest disrupted adipocyte function/hypertrophy. We assessed changes in AT density after antiretroviral therapy (ART) initiation and associations with immunometabolic parameters.MethodsIn a prospective randomized clinical trial of ART initiation, L4-L5 abdominal CT scans measured subcutaneous AT (SAT) and visceral AT (VAT) area and density in treatment-naive PLWH randomized to tenofovir-emtricitabine plus ritonavir-boosted atazanavir, ritonavir-boosted darunavir, or raltegravir. Linear regression models compared week 0 and week 96 levels, and 96-week changes, in SAT and VAT density (in Hounsfield units [HU]). Spearman correlations assessed relationships between AT density and immunometabolic parameters.ResultsOf the 228 participants, 89% were male and 44% were white non-Hispanic. Median age was 36 years, baseline HIV-1 RNA was 4.6 log10 copies/mL, and CD4+ T-cell count was 344 cells/μL. Over 96 weeks, SAT and VAT HU decreased significantly in all arms. Less dense week 96 SAT and VAT density correlated with higher high-density lipoprotein (HDL) cholesterol and adiponectin (r = 0.19-0.30) levels and lower interleukin 6, non-HDL cholesterol, triglyceride, leptin, and homeostatic model assessment of insulin resistance (r = -0.23 to -0.68) levels at week 96 after adjusting for baseline CD4+ T-cell count, HIV-1 RNA, and baseline AT area.ConclusionsFollowing virologic suppression, lower SAT and VAT density was associated with greater plasma measures of systemic inflammation, lipid disturbances, and insulin resistance independent of AT area, suggesting that changes in AT density with ART may lead to adverse health outcomes independent of AT quantity.Clinical trials registrationNCT00851799.
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- 2021
16. Design and methods of a randomized trial testing "Advancing care for COPD in people living with HIV by implementing evidence-based management through proactive E-consults (ACHIEVE)"
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Ives, Jennifer, Bagchi, Subarna, Soo, Sherilynn, Barrow, Cera, Akgün, Kathleen M., Erlandson, Kristine M., Goetz, Matthew, Griffith, Matthew, Gross, Robert, Hulgan, Todd, Moanna, Abeer, Soo Hoo, Guy W., Weintrob, Amy, Wongtrakool, Cherry, Adams, Scott V., Sayre, George, Helfrich, Christian D., Au, David H., and Crothers, Kristina
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- 2023
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17. Abstract 14771: Chronotropic Incompetence and Response to Exercise Training by HIV Status in the Exercise for Healthy Aging Study
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Durstenfeld, Matthew S, Wilson, Melissa P, Jankowski, Catherine, Ditzenberger, Grace L, Longenecker, Chris T, and Erlandson, Kristine M
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- 2023
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18. Outcomes of a Career Development Award (Pre-K) Mock Review Program for Postdoctoral Fellows and Early-Career Faculty
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Castillo-Mancilla, Jose R., Erlandson, Kristine M., Hecker, Emily R., Komaie, Goldie, Shomaker, Lauren B., Cicutto, Lisa, Mankin, Galit, and Maclean, Paul
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- 2023
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19. The Current State of HIV and Aging: Findings Presented at the 10th International Workshop on HIV and Aging
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Shiau, Stephanie, Bender, Alexis A, O'Halloran, Jane A, Sundermann, Erin, Aggarwal, Juhi, Althoff, Keri N, Baker, Jason V, Deeks, Steven, Fried, Linda P, Karpiak, Stephen, Karris, Maile Y, Marcotte, Thomas D, Nachega, Jean B, Margolick, Joseph B, Erlandson, Kristine M, and Moore, David J
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Biomedical and Clinical Sciences ,Clinical Sciences ,Aging ,HIV/AIDS ,Infectious Diseases ,Infection ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Comorbidity ,Disease Management ,Female ,HIV ,HIV Infections ,Humans ,Loneliness ,Male ,Middle Aged ,New York City ,Phenotype ,Prevalence ,Public Health ,aging ,comorbidities ,multidisciplinary ,Virology ,Clinical sciences - Abstract
With increasing effectiveness of antiretroviral therapy, people with HIV (PWH) are living longer and the prevalence of older PWH continues to increase. Accordingly, PWH are experiencing an increased burden of age-related comorbidities. With this shifting demographics, clinicians and researchers face additional challenges in how to identify, address, and manage the complex intersections of HIV- and aging-related conditions. Established in 2009, the International Workshop on HIV and Aging brings together clinicians and researchers in cross-disciplinary fields along with community advocates and PWH to address the multidisciplinary nature of HIV and aging. This article summarizes plenary talks from the 10th Annual International Workshop on HIV and Aging, which took place in New York City on October 10 and 11, 2019. Presentation topics included the following: the burdens of HIV-associated comorbidities, aging phenotypes, community engagement, and loneliness; these issues are especially important for older PWH, considering the current COVID-19 pandemic. We also discuss broad questions and potential directions for future research necessary to better understand the interaction between HIV and aging.
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- 2020
20. Rehabilitation Therapy Allocation and Changes in Physical Function Among Patients Hospitalized Due to COVID-19: A Retrospective Cohort Analysis
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Rauzi, Michelle R., Ridgeway, Kyle J., Wilson, Melissa P., Jolley, Sarah E., Nordon-Craft, Amy, Stevens-Lapsley, Jennifer E., and Erlandson, Kristine M.
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Rehabilitation nursing -- Evaluation - Abstract
Objective. Limited staffing and initial transmission concerns have limited rehabilitation services during the COVID-19 pandemic. The purpose of this analysis was to determine the associations between Activity Measure for Post-Acute Care (AM-PAC) mobility categories and allocation of rehabilitation, and in-hospital AM-PAC score change and receipt of rehabilitation services for patients with COVID-19. Methods. This was a retrospective cohort study of electronic health record data from 1 urban hospital, including adults with a COVID-19 diagnosis, admitted August 2020 to April 2021. Patients were stratified by level of medical care (intensive care unit [ICU] and floor). Therapy allocation (referral for rehabilitation, receipt of rehabilitation, and visit frequency) was the primary outcome; change in AM-PAC score was secondary. AM-PAC Basic Mobility categories (None [21-24], Minimum [18-21], Moderate [10-17], and Maximum [6-9]) were the main predictor variable. Primary analysis included logistic and linear regression, adjusted for covariates. Results. A total of 1397 patients (ICU: n = 360; floor: n = 1037) were included. AM-PAC mobility category was associated with therapy allocation outcomes for floor but not patients in the ICU: the Moderate category had greater adjusted odds of referral (adjusted odds ratio [aOR] = 10.88; 95% CI = 5.71-21.91), receipt of at least 1 visit (aOR = 3.45; 95% CI = 1.51 -8.55), and visit frequency (percentage mean difference) (aOR = 42.14; 95% CI = 12.45-79.67). The secondary outcome of AM-PAC score improvement was highest for patients in the ICU who were given at least 1 rehabilitation therapy visit (aOR = 5.31; 95% CI = 1.90-15.52). Conclusion. AM-PAC mobility categories were associated with rehabilitation allocation outcomes for floor patients. AM-PAC score improvement was highest among patients requiring ICU-level care with at least 1 rehabilitation therapy visit. Impact. Use of AM-PAC Basic Mobility categories may help improve decisions for rehabilitation therapy allocation among patients who do not require critical care, particularly during times of limited resources. Keywords: Acute Care, Hospitalization, Mobility, Rehabilitation, Introduction As of September 2021, more than 3 million patients were hospitalized in the United States with disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (ie, COVID-19). [...]
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- 2023
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21. Credible learning of hydroxychloroquine and dexamethasone effects on COVID-19 mortality outside of randomized trials
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Hazlett, Chad, Wulf, David Ami, Pasaniuc, Bogdan, Arah, Onyebuchi A, Erlandson, Kristine M, and Montague, Brian T
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Epidemiology ,Health Sciences ,Cardiovascular ,Clinical Research ,Neurodegenerative ,Clinical Trials and Supportive Activities ,Good Health and Well Being - Abstract
Objectives To investigate the effectiveness of hydroxychloroquine and dexamethasone on coronavirus disease (COVID-19) mortality using patient data outside of randomized trials. Design Phenotypes derived from electronic health records were analyzed using the stability-controlled quasi-experiment (SCQE) to provide a range of possible causal effects of hydroxy-chloroquine and dexamethasone on COVID-19 mortality. Setting and participants Data from 2,007 COVID-19 positive patients hospitalized at a large university hospital system over the course of 200 days and not enrolled in randomized trials were analyzed using SCQE. For hyrdoxychloroquine, we examine a high-use cohort (n=766, days 1 to 43) and a later, low-use cohort (n=548, days 44 to 82). For dexamethasone, we examine a low-use cohort (n=614, days 44 to 101) and high-use cohort (n=622, days 102 to 200). Outcome measure 14-day mortality, with a secondary outcome of 28-day mortality. Results Hydroxycholoroquine could only have been significantly (p
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- 2020
22. Current Challenges and Solutions in Research and Clinical Care of Older Persons Living with HIV: Findings Presented at the 9th International Workshop on HIV and Aging
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Sundermann, Erin E, Erlandson, Kristine M, Pope, Caitlin N, Rubtsova, Anna, Montoya, Jessica, Moore, Alison A, Marzolini, Catia, O'Brien, Kelly K, Pahwa, Savita, Payne, Brendan AI, Rubin, Leah H, Walmsley, Sharon, Haughey, Norman J, Montano, Monty, Karris, Maile Y, Margolick, Joseph B, and Moore, David J
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,HIV/AIDS ,Infectious Diseases ,Sexually Transmitted Infections ,Neurosciences ,Aging ,Infection ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Comorbidity ,Congresses as Topic ,Disease Management ,Female ,HIV Infections ,Humans ,Inflammation ,Life Expectancy ,Male ,Menopause ,Research ,HIV ,aging ,comorbidities ,inflammation ,polypharmacy ,intervention ,Virology ,Clinical sciences - Abstract
In the era of effective antiretroviral therapy, the number of older people with HIV (PWH) is increasing, and those aging with HIV are experiencing an increasing burden of age-associated comorbidities. Life expectancy among older PWH is approaching that of demographically comparable HIV-uninfected (HIV-) adults. With this changing demographic of PWH come new challenges for researchers and clinicians in how to identify, address, and manage the complex interplay of treated HIV infection and aging-associated factors. In response to these challenges, the annual International Workshop on HIV and Aging was initiated in 2009 as a multidisciplinary platform for scientific discourse on the research and clinical complications arising from the aging population of PWH. The multidisciplinary nature of the workshop has resulted in a wide range of topics addressed over the past 9 years, from basic mechanisms in aging and HIV pathogenesis, to epidemiology of aging within large cohorts, interventions, and implementation of clinical programs. Herein, we summarize the key topics discussed at the 9th Annual International Workshop on HIV and Aging 2018, including "inflammaging," mitochondrial dysfunction, exercise interventions, HIV-associated neurocognitive impairment, metabolic dysfunction, menopause, and polypharmacy. In addition to recent developments in research and clinical care, we discuss open questions and future research directions required to better understand the interaction of HIV and aging.
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- 2019
23. Gait Speed Decline Is Associated with Hemoglobin A1C, Neurocognitive Impairment, and Black Race in Persons with HIV
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Masters, Mary Clare, Perez, Jeremiah, Tassiopoulos, Katherine, Andrade, Adriana, Ellis, Ronald, Yang, Jingyan, Brown, Todd T, Palella, Frank J, and Erlandson, Kristine M
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Biomedical and Clinical Sciences ,Immunology ,HIV/AIDS ,Clinical Research ,Adult ,Black or African American ,Aging ,CD4 Lymphocyte Count ,Cohort Studies ,Female ,Glycated Hemoglobin ,HIV Infections ,Humans ,Longitudinal Studies ,Male ,Middle Aged ,Neurocognitive Disorders ,Odds Ratio ,RNA ,Viral ,Risk Factors ,Walking Speed ,gait speed ,hemoglobin A1C ,neurocognitive impairment ,aging ,Clinical Sciences ,Virology ,Clinical sciences - Abstract
Gait speed declines at a faster rate in persons with HIV (PWH) than in the general population but the risk factors associated with this decline are not well understood. In the AIDS Clinical Trials Group (ACTG) A5322 (HAILO, HIV Infection, Aging, and Immune Function Long-term Observational Study), an observational cohort study of PWH ≥40 years of age, those who developed slow gait during the first 3 years of follow-up were compared with persons who maintained normal speed. Associations with demographic and clinical covariates were assessed using multivariable logistic regression. Of 929 participants, 81% were men, 31% Black, and 20% Hispanic. Median age was 51 years [interquartile range (IQR) = 46-56]. At study entry, 92% had plasma HIV RNA
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- 2019
24. Racial Differences in the Effect of HIV Status on Motor and Pulmonary Function and Mobility Disability in Older Adults
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Lange-Maia, Brittney S., Buchman, Aron S., Leurgans, Sue E., Lamar, Melissa, Lynch, Elizabeth B., Erlandson, Kristine M., and Barnes, Lisa L.
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- 2022
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25. Exercise to Prevent Accelerated Vascular Aging in People Living With HIV
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Jones, Raymond, primary, Robinson, Austin T., additional, Beach, Lauren B., additional, Lindsey, Merry L., additional, Kirabo, Annet, additional, Hinton, Antentor, additional, Erlandson, Kristine M., additional, and Jenkins, Nathaniel D.M., additional
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- 2024
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26. Differences in Muscle Quantity and Quality by HIV Serostatus and Sex
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Erlandson, Kristine M., Langan, S., Lake, J. E., Sun, J., Sharma, A., Adrian, S., Scherzinger, A., Palella, F., Kingsley, L., Gange, S. J., Tien, P. C., Yin, M. T., and Brown, T. T.
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- 2022
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27. Pulmonary and physical function limitations in aging men with and without HIV from the Multicenter AIDS Cohort Study (MACS)
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Abdo, Mona, Kunisaki, Ken M., Morris, Alison, Stosor, Valentina, Chang, Dong, D'Souza, Gypsyamber, Crothers, Kristina, Abdel-Maksoud, Madiha, DiGuiseppi, Carolyn, Brown, Todd T, MaWhinney, Samantha, and Erlandson, Kristine M
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- 2022
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28. HIV and Aging Reconsidering the Approach to Management of Comorbidities
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Erlandson, Kristine M and Karris, Maile Y
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Research ,HIV/AIDS ,Aging ,Health Services ,Infection ,Good Health and Well Being ,Acquired Immunodeficiency Syndrome ,Comorbidity ,Disease Management ,Humans ,HIV ,Frailty ,Comprehensive geriatric assessment ,Polypharmacy ,Multimorbidity ,Clinical Sciences ,Public Health and Health Services ,Microbiology ,Clinical sciences ,Epidemiology - Abstract
Health care for older adults with human immunodeficiency virus can be highly complex, resource intensive, and carry a high administrative burden. Data from aging longitudinal cohorts and feedback from the human immunodeficiency virus community suggest that the current model is not meeting the needs of these older adults. We introduce the 6 Ms approach, which acknowledges the multicomplexity of older adults with human immunodeficiency virus, simplifies geriatric principles for non-geriatrics-trained providers, and minimizes extensive training and specialized screening tests or tools. Implementing novel approaches to care requires support at local/national levels.
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- 2019
29. Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study
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Rubin, Leah H, Gustafson, Deborah, Hawkins, Kellie L, Zhang, Long, Jacobson, Lisa P, Becker, James T, Munro, Cynthia A, Lake, Jordan E, Martin, Eileen, Levine, Andrew, Brown, Todd T, Sacktor, Ned, and Erlandson, Kristine M
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Clinical Trials and Supportive Activities ,Obesity ,Mental Health ,Clinical Research ,Prevention ,Neurosciences ,Infectious Diseases ,HIV/AIDS ,Nutrition ,Behavioral and Social Science ,Cardiovascular ,Adult ,Aged ,Aged ,80 and over ,Attention ,Body Mass Index ,Case-Control Studies ,Cognitive Dysfunction ,HIV Infections ,Humans ,Male ,Memory ,Short-Term ,Middle Aged ,Movement ,Obesity ,Abdominal ,Waist Circumference ,Clinical Sciences ,Cognitive Sciences ,Neurology & Neurosurgery - Abstract
ObjectiveObesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men.MethodsA total of 316 MWH and 656 HIV- Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA 80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV- men and 41% of MWH and 56% of HIV- men were ≥60 years, respectively.ResultsCross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV- men, and attention/working memory in HIV- men. WC was inversely associated with motor function in MWH and HIV- men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV- men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations.ConclusionHigher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV- men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
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- 2019
30. Evidence-informed practical recommendations for increasing physical activity among persons living with HIV
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Montoya, Jessica L, Jankowski, Catherine M, O'Brien, Kelly K, Webel, Allison R, Oursler, Krisann K, Henry, Brook L, Moore, David J, and Erlandson, Kristine M
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Sciences ,Exercise ,Guidelines as Topic ,HIV Infections ,Humans ,exercise ,guidelines ,HIV ,physical activity ,resistance training ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Published
- 2019
31. Frailty, Neurocognitive Impairment, or Both in Predicting Poor Health Outcomes Among Adults Living With Human Immunodeficiency Virus
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Erlandson, Kristine M, Perez, Jeremiah, Abdo, Mona, Robertson, Kevin, Ellis, Ronald J, Koletar, Susan L, Kalayjian, Robert, Taiwo, Babafemi, Palella, Frank J, and Tassiopoulos, Katherine
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Rehabilitation ,Infectious Diseases ,HIV/AIDS ,Aging ,Prevention ,7.1 Individual care needs ,Management of diseases and conditions ,Good Health and Well Being ,Adult ,Clinical Decision Rules ,Cognitive Dysfunction ,Frailty ,HIV Infections ,Humans ,Longitudinal Studies ,Male ,Middle Aged ,Prognosis ,frailty ,neurocognitive impairment ,disability ,falls ,HIV ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
BackgroundNeurocognitive impairment (NCI) is strongly associated with frailty in people living with human immunodeficiency virus (PLWH); the overlap of frailty and NCI and the impact on health outcomes in PLWH are unknown.MethodsPLWH in a longitudinal, observational study of aging completed entry evaluations for frailty and NCI. Outcomes of falls (recurrent) increased limitations in independent activities of daily living (IADL), or mortality were combined. Poisson regression models estimated prevalence ratios (PR) for ≥1 outcome over 2 years.ResultsAmong 987 participants, the median age at entry was 51 years; 19% were female; the median CD4 count was 616 cells/µL; and HIV-1 RNA was
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- 2019
32. Effect of Clonal Hematopoiesis on Cardiovascular Disease in People Living with HIV
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Wiley, Brian, Parsons, Tyler M., Burkart, Samantha, Young, Andrew L., Erlandson, Kristine M., Tassiopoulos, Katherine K., Wu, Kunling, Gurnett, Christina, Presti, Rachel M., Bolton, Kelly L., and Challen, Grant A.
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- 2022
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33. Inference following multiple imputation for generalized additive models: an investigation of the median p-value rule with applications to the Pulmonary Hypertension Association Registry and Colorado COVID-19 hospitalization data
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Bolt, Matthew A., MaWhinney, Samantha, Pattee, Jack W., Erlandson, Kristine M., Badesch, David B., and Peterson, Ryan A.
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- 2022
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34. Prospective telehealth analysis of functional performance, frailty, quality of life, and mental health after COVID-19 hospitalization
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Capin, Jacob J., Wilson, Melissa P., Hare, Kristine, Vempati, Swati, Little, Carley E., McGregor, Donna, Castillo-Mancilla, Jose, Stevens-Lapsley, Jennifer E., Jolley, Sarah E., and Erlandson, Kristine M.
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- 2022
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35. Association of Phenotypic Aging Marker with comorbidities, frailty and inflammatory markers in people living with HIV
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Han, Win Min, Apornpong, Tanakorn, Gatechompol, Sivaporn, Ubolyam, Sasiwimol, Chattranukulchai, Pairoj, Wattanachanya, Lalita, Siwamogsatham, Sarawut, Kerr, Stephen J., Erlandson, Kristine M., and Avihingsanon, Anchalee
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- 2022
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36. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors.
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Russo, Samuel C., Ockene, Mollie W., Arpante, Allison K., Johnson, Julia E., Hang Lee, Toribio, Mabel, Stanley, Takara L., Hadigan, Colleen M., Grinspoon, Steven K., Erlandson, Kristine M., and Fourman, Lindsay T.
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- 2024
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37. Risk factors for progression from prediabetes to diabetes among older people with HIV.
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Masters, Mary Clare, Tassiopoulos, Katherine, Yajing Bao, Kunling Wu, Koletar, Susan L., Rubin, Leah H., Jingyan Yang, Overton, Edgar T., Letendre, Scott, Brown, Todd T., Erlandson, Kristine M., and Palella, Frank J.
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- 2024
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38. Differentiation of Prior SARS-CoV-2 Infection and Postacute Sequelae by Standard Clinical Laboratory Measurements in the RECOVER Cohort.
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Erlandson, Kristine M., Geng, Linda N., Selvaggi, Caitlin A., Thaweethai, Tanayott, Chen, Peter, Erdmann, Nathan B., Goldman, Jason D., Henrich, Timothy J., Hornig, Mady, Karlson, Elizabeth W., Katz, Stuart D., Kim, C., Cribbs, Sushma K., Laiyemo, Adeyinka O., Letts, Rebecca, Lin, Janet Y., Marathe, Jai, Parthasarathy, Sairam, Patterson, Thomas F., and Taylor, Brittany D.
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- *
BIOMARKERS , *PLATELET count , *PATHOLOGICAL laboratories , *SARS-CoV-2 , *REGRESSION analysis - Abstract
This study evaluated whether SARS-CoV-2 infection led to persistent changes in common clinical laboratory tests in people with prior infection compared with those without prior infection and whether people with postacute sequelae of SARS-CoV-2 infection (PASC) have persistent laboratory changes compared with those who are unlikely to have PASC. Visual Abstract. Differentiation of Prior SARS-CoV-2 Infection and Postacute Sequelae by Standard Clinical Laboratory Measurements in the RECOVER Cohort: This study evaluated whether SARS-CoV-2 infection led to persistent changes in common clinical laboratory tests in people with prior infection compared with those without prior infection and whether people with postacute sequelae of SARS-CoV-2 infection (PASC) have persistent laboratory changes compared with those who are unlikely to have PASC. Background: There are currently no validated clinical biomarkers of postacute sequelae of SARS-CoV-2 infection (PASC). Objective: To investigate clinical laboratory markers of SARS-CoV-2 and PASC. Design: Propensity score–weighted linear regression models were fitted to evaluate differences in mean laboratory measures by prior infection and PASC index (≥12 vs. 0). (ClinicalTrials.gov: NCT05172024) Setting: 83 enrolling sites. Participants: RECOVER-Adult cohort participants with or without SARS-CoV-2 infection with a study visit and laboratory measures 6 months after the index date (or at enrollment if >6 months after the index date). Participants were excluded if the 6-month visit occurred within 30 days of reinfection. Measurements: Participants completed questionnaires and standard clinical laboratory tests. Results: Among 10 094 participants, 8746 had prior SARS-CoV-2 infection, 1348 were uninfected, 1880 had a PASC index of 12 or higher, and 3351 had a PASC index of zero. After propensity score adjustment, participants with prior infection had a lower mean platelet count (265.9 × 10 9 cells/L [95% CI, 264.5 to 267.4 × 10 9 cells/L]) than participants without known prior infection (275.2 × 10 9 cells/L [CI, 268.5 to 282.0 × 10 9 cells/L]), as well as higher mean hemoglobin A 1c (HbA 1c) level (5.58% [CI, 5.56% to 5.60%] vs. 5.46% [CI, 5.40% to 5.51%]) and urinary albumin–creatinine ratio (81.9 mg/g [CI, 67.5 to 96.2 mg/g] vs. 43.0 mg/g [CI, 25.4 to 60.6 mg/g]), although differences were of modest clinical significance. The difference in HbA 1c levels was attenuated after participants with preexisting diabetes were excluded. Among participants with prior infection, no meaningful differences in mean laboratory values were found between those with a PASC index of 12 or higher and those with a PASC index of zero. Limitation: Whether differences in laboratory markers represent consequences of or risk factors for SARS-CoV-2 infection could not be determined. Conclusion: Overall, no evidence was found that any of the 25 routine clinical laboratory values assessed in this study could serve as a clinically useful biomarker of PASC. Primary Funding Source: National Institutes of Health. [ABSTRACT FROM AUTHOR]
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- 2024
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39. Sex-Biased Associations of Circulating Ferroptosis Inhibitors with Reduced Lipid Peroxidation and Better Neurocognitive Performance in People with HIV.
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Kaur, Harpreet, Alluri, Ravi K., Wu, Kunling, Kalayjian, Robert C., Bush, William S., Palella, Frank J., Koletar, Susan L., Hileman, Corrilynn O., Erlandson, Kristine M., Ellis, Ronald J., Bedimo, Roger J., Taiwo, Babafemi O., Tassiopoulos, Katherine K., and Kallianpur, Asha R.
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HIV-positive persons ,OXIDATIVE stress ,ODDS ratio ,PEROXIDATION ,BIOMARKERS ,FERRITIN - Abstract
Ferroptosis is implicated in viral neuropathogenesis and may underlie HIV-associated neurocognitive impairment (NCI). Emerging data also suggest differences in brain iron transport by sex. We hypothesized that circulating ferritins that inhibit ferroptosis associate with neurocognitive function and NCI in people with HIV (PWH) in a sex-biased manner. Serum ferritin heavy-chain-1 (FTH1), ferritin light-chain (FTL), and urinary F
2 -isoprostanes (uF2 -isoPs, specific lipid peroxidation marker) were quantified in 324 PWH (including 61 women) with serial global (NPZ-4) and domain-specific neurocognitive testing. Biomarker associations with neurocognitive test scores and NCIs were evaluated by multivariable regression; correlations with uF2 -isoPs were also assessed. Higher FTL and FTH1 levels were associated with less NCI in all PWH (adjusted odds ratios 0.53, 95% confidence interval (95% CI) 0.36–0.79 and 0.66, 95% CI 0.45–0.97, respectively). In women, higher FTL and FTH1 were also associated with better NPZ-4 (FTL adjusted beta (β) = 0.15, 95% CI 0.02–0.29; FTL-by-sex βinteraction = 0.32, p = 0.047) and domain-specific neurocognitive test scores. Effects on neurocognitive performance persisted for up to 5 years. Levels of both ferritins correlated inversely with uF2 -isoPs in women (FTL: rho = −0.47, p < 0.001). Circulating FTL and FTH1 exert sustained, sex-biased neuroprotective effects in PWH, possibly by protecting against iron-mediated lipid peroxidation (ferroptosis). Larger studies are needed to confirm the observed sex differences and further delineate the underlying mechanisms. [ABSTRACT FROM AUTHOR]- Published
- 2024
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40. Low Rates of Vaccination for Herpes Zoster in Older People Living With HIV
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Erlandson, Kristine M, Streifel, Amber, Novin, Alexander R, Hawkins, Kellie L, Foster, Clayton, Langness, Jacob, Bessesen, Mary, Falutz, Julian, Moanna, Abeer, Looney, David, Johns, Scott T, Nguyen, Joseph B, Oxman, Michael N, and Levin, Myron J
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Aging ,Vaccine Related ,Infectious Diseases ,HIV/AIDS ,Immunization ,Management of diseases and conditions ,Prevention of disease and conditions ,and promotion of well-being ,3.4 Vaccines ,7.1 Individual care needs ,Infection ,Good Health and Well Being ,Aged ,Aged ,80 and over ,Colorado ,Female ,HIV Infections ,Health Services Accessibility ,Herpes Zoster ,Herpes Zoster Vaccine ,Humans ,Male ,Middle Aged ,Vaccination Coverage ,HIV ,frail elderly ,herpes zoster ,herpes zoster vaccine ,immunization schedule ,Virology ,Clinical sciences - Abstract
Herpes zoster (HZ) occurs at a higher age-specific rate in people living with HIV (PLWH) than in the general population. We implemented a quality improvement study to assess herpes zoster vaccine (HZV) usage among PLWH, assess HZV usage after additional reminders/prompts, and identify barriers to HZV among older PLWH. HZV rates in PLWH were determined in six institutions with varying payment structures. For the intervention, Part 1, PLWH eligible for HZV at the University of Colorado were identified, and providers were notified of patient eligibility. In Part 2, in addition to provider notification, an order for HZV was placed in the patient's chart before a clinic appointment. HZ vaccination rates ranged from 1.5% to 42.4% at six sites. Before the intervention, 21.3% of eligible University of Colorado patients had received HZV. An additional 8.3% received HZV with Part 1 and 17.8% with Part 2 interventions. At completion, a total of 53.2% of eligible patients had received HZV through routine clinical care or the interventions. Insurance coverage concern was cited as a common reason for not receiving HZV. Minor adverse reactions occurred in 26.7% patients and did not require medical care. HZV coverage was low at a majority of sites. Clinical reminders with links to vaccination orders or preplaced vaccination orders led to improved HZV coverage in our clinic, but published guidelines for use of HZV in PLWH and improvement in logistic or insurance barriers to HZV receipt are paramount to improved HZV coverage.
- Published
- 2018
41. Can Biomarkers Advance HIV Research and Care in the Antiretroviral Therapy Era?
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Justice, Amy C, Erlandson, Kristine M, Hunt, Peter W, Landay, Alan, Miotti, Paolo, and Tracy, Russell P
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Infectious Diseases ,Clinical Trials and Supportive Activities ,Clinical Research ,Prevention ,Aging ,HIV/AIDS ,Aetiology ,2.1 Biological and endogenous factors ,Infection ,Good Health and Well Being ,AIDS Dementia Complex ,AIDS-Associated Nephropathy ,Anti-Retroviral Agents ,Biomarkers ,Biomedical Research ,Cardiovascular Diseases ,Drug Discovery ,HIV Infections ,HIV-Associated Lipodystrophy Syndrome ,Humans ,Sustained Virologic Response ,Biomarker ,index ,inflammation ,HIV ,therapeutic discovery ,Biological Sciences ,Medical and Health Sciences ,Microbiology - Abstract
Despite achieving human immunodeficiency virus type 1 (HIV-1) RNA suppression below levels of detection and, for most, improved CD4+ T-cell counts, those aging with HIV experience excess low-level inflammation, hypercoagulability, and immune dysfunction (chronic inflammation), compared with demographically and behaviorally similar uninfected individuals. A host of biomarkers that are linked to chronic inflammation are also associated with HIV-associated non-AIDS-defining events, including cardiovascular disease, many forms of cancer, liver disease, renal disease, neurocognitive decline, and osteoporosis. Furthermore, chronic HIV infection may interact with long-term treatment toxicity and weight gain after ART initiation. These observations suggest that future biomarker-guided discovery and treatment may require attention to multiple biomarkers and, possibly, weighted indices. We are clinical trialists, epidemiologists, pragmatic trialists, and translational scientists. Together, we offer an operational definition of a biomarker and consider how biomarkers might facilitate progress along the translational pathway from therapeutic discovery to intervention trials and clinical management among people aging with or without HIV infection.
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- 2018
42. Cytomegalovirus IgG is Associated With Physical Function But Not Muscle Density in People With HIV
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Abidi, Maheen Z., primary, Umbleja, Triin, additional, Overton, Edgar T., additional, Burdo, Tricia, additional, Flynn, Jacqueline M., additional, Lu, Michael T., additional, Taron, Jana, additional, Schnittman, Samuel R., additional, Fitch, Kathleen V., additional, Zanni, Markella V., additional, Fichtenbaum, Carl J., additional, Malvestutto, Carlos, additional, Aberg, Judith A., additional, Fulda, Evelynne S., additional, Eckard, Allison Ross, additional, Manne-Goehler, Jennifer, additional, Tuan, Jessica J., additional, Ribaudo, Heather J., additional, Douglas, Pamela S., additional, Grinspoon, Steven K., additional, Brown, Todd T., additional, and Erlandson, Kristine M., additional
- Published
- 2024
- Full Text
- View/download PDF
43. Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study
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Adhiambo, Harriet Fridah, primary, Cook, Paul, additional, Erlandson, Kristine M., additional, Jankowski, Catherine, additional, Oliveira, Vitor H. F., additional, Do, Hoai, additional, Khuu, Vincent, additional, Davey, Christine Horvat, additional, and Webel, Allison R., additional
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- 2024
- Full Text
- View/download PDF
44. Predicting prognosis in COVID-19 patients using machine learning and readily available clinical data
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Campbell, Thomas W., Wilson, Melissa P., Roder, Heinrich, MaWhinney, Samantha, Georgantas, Robert W., III, Maguire, Laura K., Roder, Joanna, and Erlandson, Kristine M.
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- 2021
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45. Impact of Alcohol Misuse on Requirements for Critical Care Services and Development of Hospital Delirium in Patients With COVID-19 pneumonia
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Jolley, Sarah E., Mowry, Christopher J., Erlandson, Kristine M., Wilson, Melissa P., and Burnham, Ellen L.
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- 2023
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46. Antiretroviral initiation is associated with increased skeletal muscle area and fat content
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Erlandson, Kristine M, Fiorillo, Suzanne, Masawi, Fadzai, Scherzinger, Ann, McComsey, Grace A, Lake, Jordan E, Stein, James H, Currier, Judith S, and Brown, Todd T
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Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Infectious Diseases ,HIV/AIDS ,Clinical Research ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Adipose Tissue ,Adult ,Anthropometry ,Anti-Retroviral Agents ,Female ,HIV Infections ,Humans ,Male ,Middle Aged ,Muscle ,Skeletal ,Radiography ,Abdominal ,Tomography ,X-Ray Computed ,aging ,frailty ,HIV ,muscle density ,skeletal muscle ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveA greater burden of physical function impairment occurs in HIV-infected adults; the impact of antiretroviral therapy (ART) initiation on muscle density (less dense = more fat), a measure of muscle quality, is unknown.DesignAIDS Clinical Trials Group Study A5260s, a cardiometabolic substudy of A5257, randomized HIV-infected, ART-naive adults to ritonavir-boosted atazanavir, darunavir, or raltegravir with tenofovir/emtricitabine backbone. Single-slice abdominal computed tomography scans from baseline and week 96 were reanalyzed for total and lean muscle area and density.MethodsTwo-sample t-tests described the differences between baseline and week 96 variables. Linear regression analysis was used to explore the role of a priori identified variables and potential confounders.ResultsParticipants (n = 235) were mostly men (90%); 31% were Black non-Hispanic; 21% were Hispanic. Over 96 weeks, small but significant increases were seen in oblique/transverse abdominal, rectus, and psoas muscle total area (range 0.21-0.83 cm; P
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- 2017
47. Disability Among Middle-Aged and Older Persons With Human Immunodeficiency Virus Infection.
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Johs, Nikolas A, Wu, Kunling, Tassiopoulos, Katherine, Koletar, Susan L, Kalayjian, Robert C, Ellis, Ronald J, Taiwo, Babafemi, Palella, Frank J, and Erlandson, Kristine M
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Humans ,HIV Infections ,Activities of Daily Living ,Cross-Sectional Studies ,Comorbidity ,Adult ,Aged ,Middle Aged ,Female ,Male ,Frailty ,HIV ,disability ,frailty ,neurocognitive impairment ,physical activity ,HIV/AIDS ,Brain Disorders ,Prevention ,Infectious Diseases ,Rehabilitation ,Clinical Research ,Aging ,Infection ,Biological Sciences ,Medical And Health Sciences ,Microbiology ,Medical and Health Sciences - Abstract
BackgroundOlder human immunodeficiency virus (HIV)-infected adults may experience higher rates of frailty and disability than the general population. Improved understanding of the prevalence, risk factors, and types of impairment can better inform providers and the healthcare system.MethodsHIV-infected participants within the AIDS Clinical Trials Group A5322 HAILO study self-reported disability by the Lawton-Brody Instrumental Activities of Daily Living (IADL) Questionnaire. Frailty was measured by 4-m walk time, grip strength, self-reported weight loss, exhaustion, and low activity. Logistic regression models identified characteristics associated with any IADL impairment. Agreement between IADL impairment and frailty was assessed using the weighted kappa statistic.ResultsOf 1015 participants, the median age was 51 years, 15% were aged ≥60 years, 19% were female, 29% black, and 20% Hispanic. At least 1 IADL impairment was reported in 18% of participants, most commonly with housekeeping (48%) and transportation (36%) and least commonly with medication management (5%). In multivariable models, greater disability was significantly associated with neurocognitive impairment, lower education, Medicare/Medicaid insurance (vs private/other coverage), smoking, and low physical activity. Although a greater proportion of frail participants had IADL impairment (52%) compared to non-frail (11%) persons, agreement was poor (weighted kappa
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- 2017
48. Practical Review of Recognition and Management of Obesity and Lipohypertrophy in Human Immunodeficiency Virus Infection
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Lake, Jordan E, Stanley, Takara L, Apovian, Caroline M, Bhasin, Shalendar, Brown, Todd T, Capeau, Jaqueline, Currier, Judith S, Dube, Michael P, Falutz, Julian, Grinspoon, Steven K, Guaraldi, Giovanni, Martinez, Esteban, McComsey, Grace A, Sattler, Fred R, and Erlandson, Kristine M
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Immunology ,Infectious Diseases ,Prevention ,Obesity ,Clinical Research ,Nutrition ,HIV/AIDS ,Aetiology ,2.2 Factors relating to the physical environment ,2.1 Biological and endogenous factors ,Infection ,Metabolic and endocrine ,Good Health and Well Being ,Adiposity ,Anti-HIV Agents ,Antiretroviral Therapy ,Highly Active ,CD4 Lymphocyte Count ,Disease Management ,Female ,HIV Infections ,HIV-Associated Lipodystrophy Syndrome ,Humans ,Male ,Risk Factors ,human immunodeficiency virus ,obesity ,lipohypertrophy ,antiretroviral therapy ,antiretroviral therapy. ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundObesity and lipohypertrophy are common in treated human immunodeficiency virus (HIV) infection and contribute to morbidity and mortality among HIV-infected adults on antiretroviral therapy (ART).MethodsWe present a consensus opinion on the diagnosis, clinical consequences, and treatment of excess adiposity in adults with treated HIV infection.ResultsObesity and lipohypertrophy commonly occur among HIV-infected adults on ART and may have overlapping pathophysiologies and/or synergistic metabolic consequences. Traditional, HIV-specific, and ART-specific risk factors all contribute. The metabolic and inflammatory consequences of excess adiposity are critical drivers of non-AIDS events in this population. Although promising treatment strategies exist, further research is needed to better understand the pathophysiology and optimal treatment of obesity and lipohypertrophy in the modern ART era.ConclusionsBoth generalized obesity and lipohypertrophy are prevalent among HIV-infected persons on ART. Aggressive diagnosis and management are key to the prevention and treatment of end-organ disease in this population and critical to the present and future health of HIV-infected persons.
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- 2017
49. Association Between Frailty and Components of the Frailty Phenotype With Modifiable Risk Factors and Antiretroviral Therapy
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Erlandson, Kristine M, Wu, Kunling, Koletar, Susan L, Kalayjian, Robert C, Ellis, Ronald J, Taiwo, Babafemi, Jr, Palella Frank J, and Tassiopoulos, Katherine
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HIV ,frail elderly ,muscle strength ,mobility limitation ,antiretroviral therapy ,Medical And Health Sciences ,Biological Sciences ,Microbiology ,Medical and Health Sciences - Published
- 2017
50. Frailty and Components of the Frailty Phenotype are Associated with Modifiable Risk Factors and Antiretroviral Therapy.
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Erlandson, Kristine M, Wu, Kunling, Koletar, Susan L, Kalayjian, Robert C, Ellis, Ronald J, Taiwo, Babafemi, Palella, Frank J, and Tassiopoulos, Katherine
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Infectious Diseases ,Brain Disorders ,Clinical Trials and Supportive Activities ,Clinical Research ,Prevention ,HIV/AIDS ,Aging ,2.1 Biological and endogenous factors ,2.3 Psychological ,social and economic factors ,6.1 Pharmaceuticals ,Medical And Health Sciences ,Biological Sciences ,Microbiology ,Medical and Health Sciences - Published
- 2017
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