Abstract
Purpose: Despite well-known ocular complications of HIV-related immune suppression, few studies have examined the prevalence and consequences of visual impairment among aging long-term survivors of HIV. Design: Retrospective cohort study. Methods: Aging HIV-infected (HIV+) men who have sex with men (MSM) and HIV-uninfected (HIV−) MSM controls reported their difficulty performing 6 vision-dependent tasks (difficulty defined as: no, a little, moderate, and extreme difficulty). Relationships were examined using logistic regression, regressing each outcome separately on categorical visual function responses, with missing data multiply imputed. Results: There were 634 age-matched pairs for a total sample of 1,268 MSM of 1,700 MSM with available data. The median age was 60 years old (interquartile range [IQR], 54, 66), and 23% were African American. Among HIV+ men, 95% were virally suppressed (viral load <400 copies/mL). HIV+ men were more likely to report moderate or extreme difficulty performing at least 1 task (21% for HIV+ compared to 13% for HIV−; P <.01). Participants reporting extreme vision-related difficulty performing at least 1 task had 11.2 times the odds of frailty (95% confidence interval [CI], 5.2-23.9), 2.6 times the odds of a slow gait speed (95% CI, 1.4-4.8), and 3.2 times the odds of impaired instrumental activities of daily living (95% CI: 1.6-6.3) compared to those reporting no vision-related difficulty on any task. Conclusions: Perceived vision difficulty was more common among older HIV+ MSM than age-matched HIV− MSM controls and was associated with higher risk of depression and physical function loss among MSM.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 268-278 |
| Number of pages | 11 |
| Journal | American journal of ophthalmology |
| Volume | 218 |
| DOIs | |
| State | Published - Oct 2020 |
Funding
Funding/Support: Supported by National Institute of Allergy and Infectious Diseases (NIAID) grants U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, UM1-AI35043, co-funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects in the MACS was provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders ( NIDCD ). Collection of MACS data was supported by Johns Hopkins University grant ICTR UL1-TR001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, Johns Hopkins ICTR, or NCATS. The MACS website is located at http://www.statepi.jhsph.edu/macs/macs.html . All authors have completed and submitted the ICMJE form for Disclosure of Potential Conflicts of Interest and none were reported. Funding/Support: Supported by National Institute of Allergy and Infectious Diseases (NIAID) grants U01-AI35039, U01-AI35040, U01-AI35041, U01-AI35042, UM1-AI35043, co-funding from the National Cancer Institute (NCI), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH). Targeted supplemental funding for specific projects in the MACS was provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). Collection of MACS data was supported by Johns Hopkins University grant ICTR UL1-TR001079 from the National Center for Advancing Translational Sciences (NCATS) a component of the National Institutes of Health (NIH). Targeted supplemental funding for specific projects was also provided by the National Heart, Lung, and Blood Institute (NHLBI), and the National Institute on Deafness and Communication Disorders (NIDCD). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the NIH, Johns Hopkins ICTR, or NCATS. The MACS website is located at http://www.statepi.jhsph.edu/macs/macs.html. Financial disclosures: The authors have reported that they have no relationships relevant to the contents of this paper to disclose. The authors thank collaborators, staff, and participants in MACS. Data were collected by the MACS centers Johns Hopkins University, Bloomberg School of Public Health: Joseph B. Margolick (PI), Jay Bream, Todd Brown, Barbara Crain, Adrian Dobs, Richard Elion, Richard Elion, Michelle Estrella, Lisette Johnson-Hill, Sean Leng, Anne Monroe, Cynthia Munro, Michael W. Plankey, Wendy Post, Ned Sacktor, Jennifer Schrack, and Chloe Thio; the Northwestern University Feinberg School of Medicine and Cook County Bureau of Health Services: Steven M. Wolinsky (PI), John P. Phair, Sheila Badri, Dana Gabuzda, Frank J. Palella, Jr. SudhirPenugonda, Susheel Reddy, Matthew Stephens, and Linda Teplin; the University of California Los Angeles, Schools of Public Health and Medicine: Roger Detels (PI), Otoniel Mart?nez-Maza (co-P I), Aaron Aronow, Peter Anton, Robert Bolan, Elizabeth Breen, Anthony Butch, Shehnaz Hussain, Beth Jamieson, Eric N. Miller, John Oishi, Harry Vinters, Dorothy Wiley, Mallory Witt, Otto Yang, Stephen Young, and Zuo Feng Zhang; the University of Pittsburgh Graduate School of Public Health: Charles R. Rinaldo (PI), Lawrence A. Kingsley (co-PI), James T. Becker, Phalguni Gupta, Kenneth Ho, Susan Koletar, Jeremy J. Martinson, John W. Mellors, Anthony J. Silvestre, and Ronald D. Stall; the Data Coordinating Center, Johns Hopkins University Bloomberg School of Public Health: Lisa P. Jacobson (PI), Gypsyamber D'Souza (co-PI), Alison Abraham, Keri Althoff, Jennifer Deal, Priya Duggal, Sabina Haberlen, Alvaro Muoz, Derek Ng, Janet Schollenberger, Eric C. Seaberg, Sol Su, and Pamela Surkan; the NIAID: Robin E. Huebner; and the NCI: Geraldina Dominguez.
ASJC Scopus subject areas
- Ophthalmology
