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Chronic/latent viral infection prevalence and estimated all-cause mortality risk among women living with HIV and HIV-negative women participating in the British Columbia CARMA-CHIWOS Collaboration (BCC3) study: preliminary findings

Title
Chronic/latent viral infection prevalence and estimated all-cause mortality risk among women living with HIV and HIV-negative women participating in the British Columbia CARMA-CHIWOS Collaboration (BCC3) study: preliminary findings
Presenter
Tetiana Povshedna
Authors
T. Povshedna * (1,2), S.L. Levy (1,2), A.R. Campbell (3,4), S.A. Swann (3,5), D. Pang (6), E.M. King (3,7), V. Nicholson (6,8), A. Kaida (3,6), M.C. Murray (3,4,9), H.C. Cote (1,2,3), the BCC3 (CIHR, CTN 335) study team
Institutions
(1) The University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Canada, (2) The University of British Columbia, Centre for Blood Research, Vancouver, Canada, (3) Women''s Health Research Institute, British Columbia Women''s Hospital and Health Centre, Vancouver, Canada, (4) British Columbia Women''s Hospital and Health Centre, Oak Tree Clinic, Vancouver, Canada, (5) The University of British Columbia Faculty of Medicine, Experimental Medicine, Vancouver, Canada, (6) Simon Fraser University, Faculty of Health Sciences, Vancouver, Canada, (7) The University of British Columbia, Department of Medicine, Faculty of Medicine, Vancouver, Canada, (8) BC Centre for Excellence in HIV/AIDS, Epidemiology and Population Health, Vancouver, Canada, (9) The University of British Columbia, Division of Infectious Diseases, Faculty of Medicine, Vancouver, Canada

BACKGROUND: Women living with HIV (WLWH) have shorter life expectancy compared to HIV-negative women, which suggests accelerated/accentuated aging. Healthy aging is affected by chronic inflammation caused by HIV and other persistent viral infections, as well as socio-structural stressors that disproportionately affect WLWH.
METHODS: The BCC3 cohort takes a holistic approach to examine healthy aging and enrolls WLWH and HIV-negative women living in British Columbia, Canada. Prevalence of 8 chronic viral infections was assessed by serology (hepatitis B and C viruses (HBV, HCV), herpes simplex viruses (HSV-1, HSV-2), Epstein-Barr virus (EBV), human herpesvirus-8 (HHV-8), and cytomegalovirus (CMV)), or self-report (varicella-zoster virus (VZV)). The Veterans Aging Cohort Study (VACS) index, which estimates 5-year all-cause mortality risk based on clinical and demographic parameters, was calculated based on data from the BCC3 survey. The groups were compared by Fisher's, Chi-Squared, and Mann-Whitney tests, as appropriate.
RESULTS: Table 1 describes demographic characteristics of the study participants. WLWH were more likely to harbor CMV (77% vs 53%, p<0.001), HSV-2 (73% vs 27%, p<0.0001), HCV (37% vs 7%, p<0.0001), and HBV (23% vs 4%, p<0.001), but not EBV (98% vs 91%, p=0.06), HSV-1 (72% vs 63%, p=0.17), VZV (74% vs 80%, p=0.3), and HHV-8 (8% vs 18%, p=0.04). After excluding participants with missing data, WLWH (n=90) had significantly higher VACS scores compared to controls (n=96) 8.2 [3.7-23.1]% vs 4.2 [3.7-10.7]%, p<0.001.


WLWH (n=100)Controls (n=100)P-value
Age (years), median [IQR] (range)
51 [42-58] (20-73)
47 [27-56] (17-80)
0.01
African/Caribbean/Black / White / Indigenous / Asian / other, %
13 / 38 / 29 / 9 / 11
3 / 53 / 3 / 24 / 7
<0.001
Graduated high school, %
6996<0.0001
Currently employed, %36570.003
Individual income <$20.000, %6433<0.0001
Have experienced homelessness, %5121<0.001
Current smoking, %4521<0.001
Current substance use, %48380.15
Current opioid use, %27110.004

CONCLUSIONS: In this interim analysis, WLWH were more likely to have 4/8 chronic/latent viruses and almost twice the estimated risk of mortality within 5 years compared to controls. These observed differences may be partially mediated through biological variables, age, and/or socio-structural factors. This type of analysis can shed light on the factors that affect aging in WLWH, to ultimately inform action(s) to improve quality of life and close the health gap between WLWH and HIV-negative women.

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