Persons with HIV on combination antiretroviral therapy (cART) are at increased risk of the premature development of age-associated non-communicable comorbidities (AANCC), including cardiovascular, chronic kidney, liver and pulmonary disease, diabetes mellitus, osteoporosis, non-AIDS associated malignancies, and neurocognitive impairment.
It has been hypothesized that even with the availability of effective cART, such individuals may be prone to accelerated ageing. The underlying pathogenesis is potentially multifactorial but may include the consequences of sustained immune activation, both systemically and within the central nervous system.
By building on an established infrastructure for conducting longitudinal HIV cohort studies in Amsterdam and London, the COBRA (Comorbidity in relation to AIDS) programme has provided a detailed, prospective evaluation of AANCC among people with HIV who are effectively treated with cART and appropriately chosen and comparable non-infected controls.
In-depth research has also been undertaken into possible mechanisms for any increased risk of comorbidities, including those associated with HIV infection and those associated with the use of antiretroviral treatment (refer to http://fp7-cobra.eu for further information). The results obtained from this research have been used to inform and adapt national and international guidelines for prevention and management of comorbidities in ageing people with HIV.
COBRA’s EU funding formally ended March 1, 2017, but scientific productivity based on collected data and biomaterial continues.
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Other research from the UCL Centre for Clinical Research, Epidemiology, Modelling and Evaluation (CREME)