Associations between serum albumin and serious non-AIDS events among people living with HIV

Andreas Ronit; Camilla I Hatleberg; Lene Ryom; Fabrice Bonnet; Wafaa El-Sadr; Peter Reiss; Rainer Weber; Christian Pradier; Stephane De Wit; Matthew Law; Antonella d'Arminio Monforte; Jens Lundgren; Amanda Mocroft; Andrew N Phillips; Caroline A Sabin; D:A:D Study Group

doi:10.1097/QAD.0000000000001900

Associations between serum albumin and serious non-AIDS events among people living with HIV

Andreas Ronit, Camilla I Hatleberg, Lene Ryom, Fabrice Bonnet, Wafaa El-Sadr, Peter Reiss, Rainer Weber, Christian Pradier, Stephane De Wit, Matthew Law, Antonella d'Arminio Monforte, Jens Lundgren, Amanda Mocroft, Andrew N Phillips, Caroline A Sabin, D:A:D Study Group

Department of Clinical Medicine

3 Citations (Scopus)

Abstract

Objective: Lower serum albumin (sAlb) has been associated with an increased risk of mortality and AIDS among people living with HIV and may be associated with the development of serious non-AIDS events (SNAEs). We evaluated the long-term association between sAlb and the risk of SNAEs. Design: Prospective multinational cohort study. Methods: D:A:D participants without SNAEs were followed from first routine sAlb value to the first of a new SNAE [cardiovascular disease (CVD), end-stage liver disease (ESLD), end-stage renal disease (ESRD), non-AIDS malignancy (NADM), death from non-AIDS cause], AIDS-death, 6 months after last visit or 1 February 2016. Poisson regression was used to determine associations between sAlb and a new SNAE, CVD, or NADM event, with adjustment for potential confounders. Models additionally tested whether the associations were modified by age, follow-up time, smoking status, CD4 and viral load. Results: Of 16 350 participants (71.8% male, median age 44 years), 1463 developed an SNAE (371 CVD, 200 ESLD, 40 ESRD, 553 NADM, 299 deaths from other non-AIDS causes) over 80 264 person-years. Increased sAlb was associated with a decreased risk of an SNAE [adjusted rate ratio per 5 g/l: SNAE 0.79 (95% confidence interval: 0.76, 0.83); CVD 0.87 (0.80, 0.94); NADM 0.88 (0.82, 0.95)]. The association did not appear to wane with additional years of follow-up (P-interaction = 0.79) but was stronger for current smokers than for never smokers (P-interaction <0.01). Conclusion: sAlb is a durable risk factor for SNAE. Future studies are needed to determine the mechanism underlying this association and to evaluate the value of sAlb in predictive tools.

Original language	English
Journal	AIDS (London, England)
Volume	32
Issue number	13
Pages (from-to)	1837-1848
Number of pages	12
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0000000000001900
Publication status	Published - 2018

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10.1097/QAD.0000000000001900

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Ronit, A., Hatleberg, C. I., Ryom, L., Bonnet, F., El-Sadr, W., Reiss, P., Weber, R., Pradier, C., De Wit, S., Law, M., d'Arminio Monforte, A., Lundgren, J., Mocroft, A., Phillips, A. N., Sabin, C. A., & D:A:D Study Group (2018). Associations between serum albumin and serious non-AIDS events among people living with HIV. AIDS (London, England), 32(13), 1837-1848. https://doi.org/10.1097/QAD.0000000000001900

Ronit, A, Hatleberg, CI, Ryom, L, Bonnet, F, El-Sadr, W, Reiss, P, Weber, R, Pradier, C, De Wit, S, Law, M, d'Arminio Monforte, A, Lundgren, J, Mocroft, A, Phillips, AN, Sabin, CA & D:A:D Study Group 2018, 'Associations between serum albumin and serious non-AIDS events among people living with HIV', AIDS (London, England), vol. 32, no. 13, pp. 1837-1848. https://doi.org/10.1097/QAD.0000000000001900

@article{7cb336fc02de45aaab83151909548462,

title = "Associations between serum albumin and serious non-AIDS events among people living with HIV",

abstract = "Objective: Lower serum albumin (sAlb) has been associated with an increased risk of mortality and AIDS among people living with HIV and may be associated with the development of serious non-AIDS events (SNAEs). We evaluated the long-term association between sAlb and the risk of SNAEs. Design: Prospective multinational cohort study. Methods: D:A:D participants without SNAEs were followed from first routine sAlb value to the first of a new SNAE [cardiovascular disease (CVD), end-stage liver disease (ESLD), end-stage renal disease (ESRD), non-AIDS malignancy (NADM), death from non-AIDS cause], AIDS-death, 6 months after last visit or 1 February 2016. Poisson regression was used to determine associations between sAlb and a new SNAE, CVD, or NADM event, with adjustment for potential confounders. Models additionally tested whether the associations were modified by age, follow-up time, smoking status, CD4 and viral load. Results: Of 16 350 participants (71.8% male, median age 44 years), 1463 developed an SNAE (371 CVD, 200 ESLD, 40 ESRD, 553 NADM, 299 deaths from other non-AIDS causes) over 80 264 person-years. Increased sAlb was associated with a decreased risk of an SNAE [adjusted rate ratio per 5 g/l: SNAE 0.79 (95% confidence interval: 0.76, 0.83); CVD 0.87 (0.80, 0.94); NADM 0.88 (0.82, 0.95)]. The association did not appear to wane with additional years of follow-up (P-interaction = 0.79) but was stronger for current smokers than for never smokers (P-interaction <0.01). Conclusion: sAlb is a durable risk factor for SNAE. Future studies are needed to determine the mechanism underlying this association and to evaluate the value of sAlb in predictive tools.",

author = "Andreas Ronit and Hatleberg, {Camilla I} and Lene Ryom and Fabrice Bonnet and Wafaa El-Sadr and Peter Reiss and Rainer Weber and Christian Pradier and {De Wit}, Stephane and Matthew Law and {d'Arminio Monforte}, Antonella and Jens Lundgren and Amanda Mocroft and Phillips, {Andrew N} and Sabin, {Caroline A} and {D:A:D Study Group}",

year = "2018",

doi = "10.1097/QAD.0000000000001900",

language = "English",

volume = "32",

pages = "1837--1848",

journal = "AIDS (London, England)",

issn = "0269-9370",

publisher = "Lippincott Williams & Wilkins",

number = "13",

}

TY - JOUR

T1 - Associations between serum albumin and serious non-AIDS events among people living with HIV

AU - Ronit, Andreas

AU - Hatleberg, Camilla I

AU - Ryom, Lene

AU - Bonnet, Fabrice

AU - El-Sadr, Wafaa

AU - Reiss, Peter

AU - Weber, Rainer

AU - Pradier, Christian

AU - De Wit, Stephane

AU - Law, Matthew

AU - d'Arminio Monforte, Antonella

AU - Lundgren, Jens

AU - Mocroft, Amanda

AU - Phillips, Andrew N

AU - Sabin, Caroline A

AU - D:A:D Study Group

PY - 2018

Y1 - 2018

N2 - Objective: Lower serum albumin (sAlb) has been associated with an increased risk of mortality and AIDS among people living with HIV and may be associated with the development of serious non-AIDS events (SNAEs). We evaluated the long-term association between sAlb and the risk of SNAEs. Design: Prospective multinational cohort study. Methods: D:A:D participants without SNAEs were followed from first routine sAlb value to the first of a new SNAE [cardiovascular disease (CVD), end-stage liver disease (ESLD), end-stage renal disease (ESRD), non-AIDS malignancy (NADM), death from non-AIDS cause], AIDS-death, 6 months after last visit or 1 February 2016. Poisson regression was used to determine associations between sAlb and a new SNAE, CVD, or NADM event, with adjustment for potential confounders. Models additionally tested whether the associations were modified by age, follow-up time, smoking status, CD4 and viral load. Results: Of 16 350 participants (71.8% male, median age 44 years), 1463 developed an SNAE (371 CVD, 200 ESLD, 40 ESRD, 553 NADM, 299 deaths from other non-AIDS causes) over 80 264 person-years. Increased sAlb was associated with a decreased risk of an SNAE [adjusted rate ratio per 5 g/l: SNAE 0.79 (95% confidence interval: 0.76, 0.83); CVD 0.87 (0.80, 0.94); NADM 0.88 (0.82, 0.95)]. The association did not appear to wane with additional years of follow-up (P-interaction = 0.79) but was stronger for current smokers than for never smokers (P-interaction <0.01). Conclusion: sAlb is a durable risk factor for SNAE. Future studies are needed to determine the mechanism underlying this association and to evaluate the value of sAlb in predictive tools.

AB - Objective: Lower serum albumin (sAlb) has been associated with an increased risk of mortality and AIDS among people living with HIV and may be associated with the development of serious non-AIDS events (SNAEs). We evaluated the long-term association between sAlb and the risk of SNAEs. Design: Prospective multinational cohort study. Methods: D:A:D participants without SNAEs were followed from first routine sAlb value to the first of a new SNAE [cardiovascular disease (CVD), end-stage liver disease (ESLD), end-stage renal disease (ESRD), non-AIDS malignancy (NADM), death from non-AIDS cause], AIDS-death, 6 months after last visit or 1 February 2016. Poisson regression was used to determine associations between sAlb and a new SNAE, CVD, or NADM event, with adjustment for potential confounders. Models additionally tested whether the associations were modified by age, follow-up time, smoking status, CD4 and viral load. Results: Of 16 350 participants (71.8% male, median age 44 years), 1463 developed an SNAE (371 CVD, 200 ESLD, 40 ESRD, 553 NADM, 299 deaths from other non-AIDS causes) over 80 264 person-years. Increased sAlb was associated with a decreased risk of an SNAE [adjusted rate ratio per 5 g/l: SNAE 0.79 (95% confidence interval: 0.76, 0.83); CVD 0.87 (0.80, 0.94); NADM 0.88 (0.82, 0.95)]. The association did not appear to wane with additional years of follow-up (P-interaction = 0.79) but was stronger for current smokers than for never smokers (P-interaction <0.01). Conclusion: sAlb is a durable risk factor for SNAE. Future studies are needed to determine the mechanism underlying this association and to evaluate the value of sAlb in predictive tools.

U2 - 10.1097/QAD.0000000000001900

DO - 10.1097/QAD.0000000000001900

M3 - Journal article

C2 - 29847331

SN - 0269-9370

VL - 32

SP - 1837

EP - 1848

JO - AIDS (London, England)

JF - AIDS (London, England)

IS - 13

ER -

Associations between serum albumin and serious non-AIDS events among people living with HIV

Abstract

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