Imperial College London
Alternate

Dr Mikaela Smit

Faculty of Medicine, School of Public Health

Honorary Research Fellow
 
 
 
//

Contact

 

mikaela.smit

 
 
//

Location

 

47 Praed StreetSt Mary's Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Smit:2015:10.1016/S1473-3099(15)00056-0,
author = {Smit, M and Brinkman, K and Geerlings, S and Smit, C and Thyagarajan, K and van, Sighem A and de, Wolf F and Hallett, TB},
doi = {10.1016/S1473-3099(15)00056-0},
journal = {Lancet Infectious Diseases},
pages = {810--818},
title = {Future challenges for clinical care of an ageing population infected with HIV: a modelling study},
url = {http://dx.doi.org/10.1016/S1473-3099(15)00056-0},
volume = {15},
year = {2015}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background The population infected with HIV is getting older and these people will increasingly develop age-relatednon-communicable diseases (NCDs). We aimed to quantify the scale of the change and the implications for HIV carein the Netherlands in the future.Methods We constructed an individual-based model of the ageing HIV-infected population, which followed patientson HIV treatment as they age, develop NCDs—including cardiovascular disease (hypertension, hypercholesterolaemia,myocardial infarctions, and strokes), diabetes, chronic kidney disease, osteoporosis, and non-AIDS malignancies—and start co-medication for these diseases. The model was parameterised by use of data for 10 278 patients from thenational Dutch ATHENA cohort between 1996 and 2010. We made projections up to 2030.Findings Our model suggests that the median age of HIV-infected patients on combination antiretroviral therapy(ART) will increase from 43·9 years in 2010 to 56·6 in 2030, with the proportion of HIV-infected patients aged50 years or older increasing from 28% in 2010 to 73% in 2030. In 2030, we predict that 84% of HIV-infected patientswill have at least one NCD, up from 29% in 2010, with 28% of HIV-infected patients in 2030 having three or moreNCDs. 54% of HIV-infected patients will be prescribed co-medications in 2030, compared with 13% in 2010, with20% taking three or more co-medications. Most of this change will be driven by increasing prevalence ofcardiovascular disease and associated drugs. Because of contraindications and drug–drug interactions, in 2030, 40%of patients could have complications with the currently recommended fi rst-line HIV regimens.Interpretation The profi le of patients in the Netherlands infected with HIV is changing, with increasing numbers ofolder patients with multiple morbidities. These changes mean that, in the near future, HIV care will increasingly need todraw on a wide range of medical disciplines, in addition to evidence-bas
AU  - Smit,M
AU  - Brinkman,K
AU  - Geerlings,S
AU  - Smit,C
AU  - Thyagarajan,K
AU  - van,Sighem A
AU  - de,Wolf F
AU  - Hallett,TB
DO  - 10.1016/S1473-3099(15)00056-0
EP  - 818
PY  - 2015///
SN  - 1473-3099
SP  - 810
TI  - Future challenges for clinical care of an ageing population infected with HIV: a modelling study
T2  - Lancet Infectious Diseases
UR  - http://dx.doi.org/10.1016/S1473-3099(15)00056-0
UR  - http://hdl.handle.net/10044/1/56567
VL  - 15
ER  -
Download