HIV and Aging
Metabolic and Aging (M+A) Study
In the setting of long term successful antiretroviral therapy (ART) conditions referred to as “metabolic” or potentially related to premature aging, including cardiovascular disease, osteoporosis, neurocognitive dysfunction, renal and endocrinologic disorders, are increasingly important determinants of the long term health of HIV-positive individuals. Their exact frequency, impact, and pathogenesis are not completely defined, including the relative contribution of traditional risk factors, demographic, HIV- and ART-related, genetic, and other factors. The Swiss HIV Cohort Study (SHCS) core project “Metabolism and Aging” (M+A) is a 6-year project that started recruiting patients ≥45 years of age in late 2013. It includes obtaining fasting urine and plasma samples, assessing bone mineral density using DXA, neurocognitive assessment by a neuropsychologist and in participants from the Zurich and Geneva center additionally assessing subclinical coronary atherosclerosis by coronary CT angiography.
Coronary CT angiography (CCTA) Study
We aim to evaluate the prevalence and characterization of subclinical coronary atherosclerosis in HIV+ persons without known coronary disease and prospectively recruited HIV-negative controls matched on age, gender, and Framingham score. The longitudinal dynamics of calcified and non-calcified coronary atherosclerosis will be assessed by obtaining coronary CT angiography (CCTA) and coronary artery calcium (CAC) determination at baseline and 2 years later, in order to compare atherosclerosis progression in HIV+ vs. HIV- negative persons.
Clinical Trial Registration
Dynamics of atherosclerosis progression in HIVinfected and HIV-uninfected persons - a longitudinal study using coronary computed tomography angiography
Swiss National Science Foundation
HIV and Liver Disease
Chronic ALT elevation is frequent in HIV-infected patients without hepatitis B and C coinfection. However, little is known about its clinical significance. Small studies found a surprisingly high number of histopathological liver abnormalities in patients with chronic elevated liver enzymes. In this study we aim to (i) evaluate the prevalence of liver fibrosis and cirrhosis in HIV-infected patients with chronic ALT elevation and no chronic viral hepatitis using non-invasive diagnostic tests (Fibroscan, FibroTest, APRI, Fib4), (ii) to find associated risk factors, including demographic, clinical and HIV-specific variables associated with significant fibrosis and cirrhosis; and (iii) to observe changes in liver stiffness values and serum marker results as a sign for fibrosis progression within 1 and 3 years.
Clinical Trial Registration
Prevalence of liver fibrosis and progression of liver fibrosis in HIV-infected, HCV/HBV-seronegative patients with chronic ALT elevation
SHCS, supported by the Swiss National Science Foundation (grant #134277)
Matching Funds by University of Zurich, Switzerland
• PD Dr. med. Philip Tarr, Division of Infectious Diseases and Hospital Epidemiology, Medizinische Universitätsklinik, Kantonsspital Baselland,
• Prof. Dr. med. Philipp Kaufmann, Clinic for Nuclear Medicine, University Hospital, Zurich
• Prof. Dr. phil. Peter Brugger, Department of Neuropsychology, University Hospital Zurich
• Dr. med. Diana Frey, Department of Rheumatology, University Hospital Zurich
• Prof. Dr. med. Beat Müllhaupt, Division of Gastroenterology and Hepatology, University Hospital Zurich
• Prof. Dr. med. Alexandra Calmy, HIV Unit, Dept. of Internal Medicine, University Hospital, Geneva.