GLOBAL ASSESSMENT OF NON-COMMUNICABLE DISEASES (NCDS) AND ESTIMATED CLINICAL RISKS IN A COHORT OF OLDER ADULTS LIVING WITH HIV/AIDS (OALHIV)

In the era of highly effective antiretroviral therapy (ART), the life expectancy of people living with HIV/AIDS (PLHIV) has approached that of HIV-negative individuals. The growing prevalence of non-communicable diseases (NCDs) has significantly contributed to morbidity and mortality in this population. The aim of this study was to evaluate the prevalence of NCDs, depression, quality of life perception, and risk stratification in PLHIV aged ≥ 50 years. Descriptive analysis of baseline data from a cohort of PLHIV aged ≥ 50 years, including both ART-naïve and virally suppressed individuals, captured in the REDCap platform. The most frequent NCDs, hepatic steatosis by elastography, depression using PHQ-9, quality of life perception by EQ-5D-5L, cardiovascular disease (CVD) risk by AAC/AHA-CV, fracture probability by FRAX Brazil 2.0, and estimated glomerular filtration rate (eGFR) by CKD-EPI were assessed. The cohort included 37 PLHIV (7 ART-naïve and 30 virally suppressed), median age 61 years; 86% cisgender men, 51% self-identified as mixed/Black race, and 59% homosexual/bisexual. Median CD4 count was 667 cells/mm³, and median CD4/CD8 ratio was 0.93. Among virally suppressed participants, median duration of infection was 20 years, 67% had been on ART ≥ 10 years, and median CD4 nadir was 271 cells/mm³. Legal substance use (alcohol/tobacco) was reported by 27%. Overall NCD prevalence was 97%, most frequently metabolic diseases (76%), CVD (49%), psychiatric disorders (43%), neurological diseases (24%), bone disorders (19%), and non-AIDS malignancies (13%). The prevalence of hepatic steatosis was 24%. The FRAX score indicated a high or very high fracture risk in 30% (n = 30/37) of participants, with median BMI, eGFR, and cardiovascular risk of 28 kg/m², 73 mL/min/1.73 m², and 10.5%, respectively. The prevalence of moderate to severe depression (PHQ-9 ≥ 10) was 8.1%.The perceived quality of life had a median score of 90, with impairments observed across all domains, the most prevalent being the anxiety/depression domain (42.9%). Despite the limited sample size, a high prevalence of NCDs was observed. Although comorbidities and symptoms of anxiety and depression were common, the overall perceived quality of life remained high, as reflected in the EQ-5D-5L scores. These findings suggest a potential positive impact of comprehensive healthcare provision for older adults living with HIV.