HIV Patients Have a High Risk for Multimorbidity

The prevalence of multimorbidity has risen among individuals with human immunodeficiency virus (HIV), according to a recent study.

Previous studies have shown that age-related conditions have become increasingly common in patients with HIV, indicating a need to investigate the impact of this prevalence on clinical care complexity.
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For their study, which was nested in the North American Acquired Immunodeficiency Syndrome (AIDS) Cohort Collaboration on Research and Design, the researchers assessed 22,969 adult patients with HIV, of whom 79% were men and 36% were black. Median age at baseline was 40 years. All patients included in the study had been exposed to antiretroviral therapy and had received clinical care between 2000 and 2009.

Multimorbidity, which was irreversible, was defined as having at least 2 of the following conditions: hypertension, diabetes, chronic kidney disease, hypercholesterolemia, end-stage liver disease, or non-AIDS-related cancer. Adjusted prevalence ratios compared demographic subgroups.

Results of the study showed that the prevalence of multimorbidity had increased from 8.2% in 2000 to 22.4% in 2009, and this association remained significant following adjustment for age. Although there was no difference in prevalence based on sex, the researchers found that blacks had a lower risk for multimorbidity compared with whites (adjusted prevalence ratio = 0.87). The incidence of multimorbidity was highest among heterosexuals compared with men who have sex with men (adjusted prevalence ratio = 1.16). The most commonly co-occurring conditions were hypertension and hypercholesterolemia.

“Multimorbidity prevalence has increased among persons living with HIV,” the researchers concluded. “Comorbidity prevention and multi-subspecialty management of increasingly complex healthcare needs will be vital to ensuring they receive needed care.”

—Christina Vogt

Reference:

Wong C, Gange SJ, Moore RD, et al; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD). Multimorbidity among persons living with HIV in the U.S. [Published online November 15, 2017]. Clin Infect Dis. https://doi.org/10.1093/cid/cix998.