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RESEARCH PRODUCT
Human Immunodeficiency Virus Infection and Diverse Physical Health Outcomes: An Umbrella Review of Meta-analyses of Observational Studies.
Jacopo DemurtasJoseph FirthBrendon StubbsPinar SoysalAi KoyanagiMichael MeilingerIgor GrabovacNicola VeroneseFrancesco Di GennaroLee SmithSarah E JacksonAdam D. AbbsSandra HaiderLin YangLin YangDaragh T. McdermottSinisa Stefanacsubject
Microbiology (medical)medicine.medical_specialtyPopulationcomorbidHIV InfectionsDisease03 medical and health sciencesPulmonary Disease Chronic Obstructive0302 clinical medicineAcquired immunodeficiency syndrome (AIDS)Meta-Analysis as TopicPre-EclampsiaPregnancyInternal medicineMedicineHumanshealth outcomes030212 general & internal medicineeducationArticles and CommentariesCOPDeducation.field_of_studyhuman immunodeficiency virusumbrella reviewbusiness.industryhuman immunodeficiency viruPublic healthIncidence (epidemiology)IncidenceAn Umbrella Review of Meta-analyses of Observational Studies.- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 2019 [Grabovac I. Veronese N. Stefanac S. Haider S. Jackson S. Koyanagi A. Meilinger M. Stubbs B. Firth J. Soysal P. et al. -Human Immunodeficiency Virus Infection and Diverse Physical Health Outcomes]HIVmedicine.diseaseComorbidityObservational Studies as TopicInfectious DiseasesCross-Sectional StudiesAcademicSubjects/MED00290health outcomeFemalebusiness030217 neurology & neurosurgeryCohort studySystematic Reviews as Topicdescription
Abstract Background Our aim was to assess both the credibility and strength of evidence arising from systematic reviews with meta-analyses of observational studies and physical health outcomes associated with human immunodeficiency virus (HIV) but not acquired immunodeficiency syndrome. Methods We performed an umbrella review of observational studies. Evidence was graded as convincing, highly suggestive, suggestive, weak, or nonsignificant. Results From 3413 studies returned, 20 were included, covering 55 health outcomes. Median number of participants was 18 743 (range 403–225 000 000). Overall, 45 (81.8%) of the 55 unique outcomes reported nominally significant summary results (P < .05). Only 5 outcomes (9.0%; higher likelihood of presence of breathlessness, higher chronic obstructive pulmonary disease [COPD] prevalence, maternal sepsis, higher risk of anemia, and higher risk of all fractures among people living with HIV [PLWHIV]) showed suggestive evidence, with P values < 10–3; only 3 (5.5%; higher prevalence of cough in cross-sectional studies, higher incidence of pregnancy-related mortality, and higher incidence of ischemic heart disease among PLWHIV in cohort studies) outcomes showed stronger evidence using a stringent P value (<10–6). None of the unique outcomes presented convincing evidence (Class I), yet 3 outcomes presented highly suggestive evidence, 5 outcomes presented suggestive evidence, and 37 outcomes presented weak evidence. Conclusions Results show highly suggestive and suggestive evidence for HIV and the presence of a cough, COPD, ischemic heart disease, pregnancy-related mortality, maternal sepsis, and bone fractures. Public health policies should reflect and accommodate these changes, especially in light of the increases in the life expectancy and the incidence of comorbidities in this population.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-08-11 | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America |