Comorbidities Among US Patients With Prevalent HIV Infection—A Trend Analysis

New treatments have improved outcomes and increased life expectancy for human immunodeficiency virus (HIV)–infected patients; however, their comorbidity burden has grown significantly and is greater than that in a matched non–HIV-infected cohort. This introduces important considerations for treatmen...

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Veröffentlicht in:The Journal of infectious diseases 2017-12, Vol.216 (12), p.1525-1533
Hauptverfasser: Gallant, Joel, Hsue, Priscilla Y., Shreay, Sanatan, Meyer, Nicole
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Sprache:eng
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Zusammenfassung:New treatments have improved outcomes and increased life expectancy for human immunodeficiency virus (HIV)–infected patients; however, their comorbidity burden has grown significantly and is greater than that in a matched non–HIV-infected cohort. This introduces important considerations for treatment choices and outcomes. Abstract Objective Quantify proportion of human immunodeficiency virus (HIV)–infected patients with specific comorbidities receiving healthcare coverage from commercial, Medicaid, and Medicare payers. Methods Data from MarketScan research databases were used to select adult HIV-infected patients from each payer. Treated HIV-infected patients were matched to HIV-negative controls. Cross-sectional analyses were performed between 2003 and 2013 among HIV-infected patients to quantify the proportion with individual comorbidities over the period, by payer. Results Overall, 36298 HIV-infected patients covered by commercial payers, 26246 covered by Medicaid payers, and 1854 covered by Medicare payers were identified between 2003 and 2013. Essential hypertension (31.4%, 39.3%, and 76.2%, respectively), hyperlipidemia (29.2%, 22.1%, and 49.6%), and endocrine disease (21.8%, 27.2%, and 54.0%) were the most common comorbidities. Comparison of data from 2003 to data from 2013 revealed significant increases across payers in the percentage of patients with the comorbidities specified above (P < .05). Across all payers, the proportions of treated HIV-infected patients with deep vein thrombosis, hepatitis C, renal impairment, thyroid disease, and liver disease from 2003 to 2013 was significantly greater (P < .05) than for matched controls. Conclusions Comorbidities are common among the aging HIV-infected population and have increased over time. There should be a consideration in treatment choices for HIV infection, including the choices of antiretroviral regimens.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jix518