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2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida

BACKGROUND: Red blood cell distribution width (RDW) is a hematologic parameter that may reflect an underlying inflammatory state. It has been linked to cardiovascular disease, metabolic syndrome and increased mortality in the general population. However, little is known about the comorbidities assoc...

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Autores principales: Presser, Javier Baez, Raja, Mohammed, Rugama, Marco Lorio, Milisavljevic, Ana, Zamora, Jose Gonzales
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252726/
http://dx.doi.org/10.1093/ofid/ofy210.1910
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author Presser, Javier Baez
Raja, Mohammed
Rugama, Marco Lorio
Milisavljevic, Ana
Zamora, Jose Gonzales
author_facet Presser, Javier Baez
Raja, Mohammed
Rugama, Marco Lorio
Milisavljevic, Ana
Zamora, Jose Gonzales
author_sort Presser, Javier Baez
collection PubMed
description BACKGROUND: Red blood cell distribution width (RDW) is a hematologic parameter that may reflect an underlying inflammatory state. It has been linked to cardiovascular disease, metabolic syndrome and increased mortality in the general population. However, little is known about the comorbidities associated with high RDW in HIV-infected patients. METHODS: We conducted a retrospective review of HIV-infected patients treated in the Ryan White Clinic of Jackson Memorial Hospital from January to December 2016. Of the 2,065 patients who attended our clinic in 2016, a sample of 317 patients was obtained. Our aim was to determine the noninfectious comorbidities associated with high RDW (≥14%) in patients with undetectable HIV viral load. Data were analyzed in SPSS 22, New York, USA. RESULTS: Our study included 317 HIV patients with undetectable HIV viral load, 123 (38.8%) females and 194 (61.2%) males with a mean age of 54.3 (SD ±9.94). Most patients were African American (52.4%) and Hispanic (39.4%). The mean CD4 count was 609.9 cells/μL (SD ±303.48) with a mean CD4/CD8 ratio of 1.04 (SD ±3.8). The mean RDW was 13.6% (SD ± 2.08). High RDW was observed in 94 (29.7%) patients. Hepatitis B and C coinfection were found in 7.6% and 11.4% of patients, respectively. 74 (23.3%) patients reported alcohol use and 103 (32.5%) patients disclosed smoking. Most patients were on antiretroviral therapy (98.4%).The preferred regimen was 2 NRTIs plus an integrase inhibitor (53%). The most frequent noninfectious comorbidities were dyslipidemia (56.8%), hypertension (52.4%), depression (26.8%) and diabetes mellitus (19.6%). In comparison with the rest of the study cohort, the patients with high RDW had a higher proportion of hypertension (61.7% vs. 48.4%, P = 0.031), stroke (7.4% vs. 0.9%, P = 0.001), congestive heart failure (10.6% vs. 2.7%, P = 0.003) and chronic kidney disease (26.6% vs. 10.3%, P < 0.001). They also had significantly lower CD4 count (555.8 vs. 632.7, P = 0.039). No difference was found in myocardial infarction, peripheral vascular disease, dementia, COPD, asthma, cancer, liver disease, dyslipidemia, depression or gastric disease. CONCLUSION: Hypertension, congestive heart failure, stroke, and chronic kidney disease were conditions associated with high RDW. Our study suggests that high RDW may be a marker of cardiovascular and renal dysfunction in well-controlled HIV-infected patients. DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62527262018-11-28 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida Presser, Javier Baez Raja, Mohammed Rugama, Marco Lorio Milisavljevic, Ana Zamora, Jose Gonzales Open Forum Infect Dis Abstracts BACKGROUND: Red blood cell distribution width (RDW) is a hematologic parameter that may reflect an underlying inflammatory state. It has been linked to cardiovascular disease, metabolic syndrome and increased mortality in the general population. However, little is known about the comorbidities associated with high RDW in HIV-infected patients. METHODS: We conducted a retrospective review of HIV-infected patients treated in the Ryan White Clinic of Jackson Memorial Hospital from January to December 2016. Of the 2,065 patients who attended our clinic in 2016, a sample of 317 patients was obtained. Our aim was to determine the noninfectious comorbidities associated with high RDW (≥14%) in patients with undetectable HIV viral load. Data were analyzed in SPSS 22, New York, USA. RESULTS: Our study included 317 HIV patients with undetectable HIV viral load, 123 (38.8%) females and 194 (61.2%) males with a mean age of 54.3 (SD ±9.94). Most patients were African American (52.4%) and Hispanic (39.4%). The mean CD4 count was 609.9 cells/μL (SD ±303.48) with a mean CD4/CD8 ratio of 1.04 (SD ±3.8). The mean RDW was 13.6% (SD ± 2.08). High RDW was observed in 94 (29.7%) patients. Hepatitis B and C coinfection were found in 7.6% and 11.4% of patients, respectively. 74 (23.3%) patients reported alcohol use and 103 (32.5%) patients disclosed smoking. Most patients were on antiretroviral therapy (98.4%).The preferred regimen was 2 NRTIs plus an integrase inhibitor (53%). The most frequent noninfectious comorbidities were dyslipidemia (56.8%), hypertension (52.4%), depression (26.8%) and diabetes mellitus (19.6%). In comparison with the rest of the study cohort, the patients with high RDW had a higher proportion of hypertension (61.7% vs. 48.4%, P = 0.031), stroke (7.4% vs. 0.9%, P = 0.001), congestive heart failure (10.6% vs. 2.7%, P = 0.003) and chronic kidney disease (26.6% vs. 10.3%, P < 0.001). They also had significantly lower CD4 count (555.8 vs. 632.7, P = 0.039). No difference was found in myocardial infarction, peripheral vascular disease, dementia, COPD, asthma, cancer, liver disease, dyslipidemia, depression or gastric disease. CONCLUSION: Hypertension, congestive heart failure, stroke, and chronic kidney disease were conditions associated with high RDW. Our study suggests that high RDW may be a marker of cardiovascular and renal dysfunction in well-controlled HIV-infected patients. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6252726/ http://dx.doi.org/10.1093/ofid/ofy210.1910 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Presser, Javier Baez
Raja, Mohammed
Rugama, Marco Lorio
Milisavljevic, Ana
Zamora, Jose Gonzales
2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title_full 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title_fullStr 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title_full_unstemmed 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title_short 2257. Noninfectious Comorbidities Associated With High RDW in HIV-Infected Patients: A Cross-Sectional Study in Miami, Florida
title_sort 2257. noninfectious comorbidities associated with high rdw in hiv-infected patients: a cross-sectional study in miami, florida
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252726/
http://dx.doi.org/10.1093/ofid/ofy210.1910
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