Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study
As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities. We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels amo...
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| Veröffentlicht in: | BMC infectious diseases 2015-10, Vol.15 (1), p.453, Article 453 |
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| creator | Gillis, Jennifer Bayoumi, Ahmed M Burchell, Ann N Cooper, Curtis Klein, Marina B Loutfy, Mona Machouf, Nima Montaner, Julio Sg Tsoukas, Chris Hogg, Robert S Raboud, Janet |
| description | As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities.
We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements.
Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements.
Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters. |
| doi_str_mv | 10.1186/s12879-015-1206-3 |
| format | Article |
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We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements.
Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements.
Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.</description><identifier>ISSN: 1471-2334</identifier><identifier>EISSN: 1471-2334</identifier><identifier>DOI: 10.1186/s12879-015-1206-3</identifier><identifier>PMID: 26496954</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adult ; Analysis ; Antiretroviral Therapy, Highly Active ; Biomarkers - analysis ; Canada ; Cohort Studies ; Coinfection ; Comorbidity ; Complications and side effects ; Drug therapy ; Enzymes - analysis ; Female ; Follow-Up Studies ; Hepatitis C - complications ; HIV Infections - drug therapy ; HIV Infections - metabolism ; Humans ; Indigenous peoples ; Infectious diseases ; Kidney Function Tests ; Lipids ; Lipids - blood ; Liver - drug effects ; Liver - enzymology ; Male ; Middle Aged ; Patient outcomes ; Risk factors ; Substance Abuse, Intravenous - complications</subject><ispartof>BMC infectious diseases, 2015-10, Vol.15 (1), p.453, Article 453</ispartof><rights>COPYRIGHT 2015 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2015</rights><rights>Gillis et al. 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c514t-eb4ead627aa8636d9bfbb4c779c707ac951870257fc152bc01fa7644862c1c883</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620739/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620739/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26496954$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gillis, Jennifer</creatorcontrib><creatorcontrib>Bayoumi, Ahmed M</creatorcontrib><creatorcontrib>Burchell, Ann N</creatorcontrib><creatorcontrib>Cooper, Curtis</creatorcontrib><creatorcontrib>Klein, Marina B</creatorcontrib><creatorcontrib>Loutfy, Mona</creatorcontrib><creatorcontrib>Machouf, Nima</creatorcontrib><creatorcontrib>Montaner, Julio Sg</creatorcontrib><creatorcontrib>Tsoukas, Chris</creatorcontrib><creatorcontrib>Hogg, Robert S</creatorcontrib><creatorcontrib>Raboud, Janet</creatorcontrib><creatorcontrib>Canadian Observational Cohort (CANOC) collaboration</creatorcontrib><creatorcontrib>The Canadian Observational Cohort (CANOC) collaboration</creatorcontrib><title>Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study</title><title>BMC infectious diseases</title><addtitle>BMC Infect Dis</addtitle><description>As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities.
We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements.
Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements.
Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.</description><subject>Adult</subject><subject>Analysis</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biomarkers - analysis</subject><subject>Canada</subject><subject>Cohort Studies</subject><subject>Coinfection</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Drug therapy</subject><subject>Enzymes - analysis</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hepatitis C - complications</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - metabolism</subject><subject>Humans</subject><subject>Indigenous peoples</subject><subject>Infectious diseases</subject><subject>Kidney Function Tests</subject><subject>Lipids</subject><subject>Lipids - blood</subject><subject>Liver - drug effects</subject><subject>Liver - 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initiating combination antiretroviral therapy: a cohort study</title><author>Gillis, Jennifer ; Bayoumi, Ahmed M ; Burchell, Ann N ; Cooper, Curtis ; Klein, Marina B ; Loutfy, Mona ; Machouf, Nima ; Montaner, Julio Sg ; Tsoukas, Chris ; Hogg, Robert S ; Raboud, Janet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-eb4ead627aa8636d9bfbb4c779c707ac951870257fc152bc01fa7644862c1c883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Analysis</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Biomarkers - analysis</topic><topic>Canada</topic><topic>Cohort Studies</topic><topic>Coinfection</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Drug therapy</topic><topic>Enzymes - analysis</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hepatitis C - complications</topic><topic>HIV Infections 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Canadian Observational Cohort (CANOC) collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study</atitle><jtitle>BMC infectious diseases</jtitle><addtitle>BMC Infect Dis</addtitle><date>2015-10-26</date><risdate>2015</risdate><volume>15</volume><issue>1</issue><spage>453</spage><pages>453-</pages><artnum>453</artnum><issn>1471-2334</issn><eissn>1471-2334</eissn><abstract>As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities.
We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements.
Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements.
Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26496954</pmid><doi>10.1186/s12879-015-1206-3</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | BMC infectious diseases, 2015-10, Vol.15 (1), p.453, Article 453 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; SpringerLink Journals - AutoHoldings; PubMed Central Open Access; Springer Nature OA Free Journals |
| subjects | Adult Analysis Antiretroviral Therapy, Highly Active Biomarkers - analysis Canada Cohort Studies Coinfection Comorbidity Complications and side effects Drug therapy Enzymes - analysis Female Follow-Up Studies Hepatitis C - complications HIV Infections - drug therapy HIV Infections - metabolism Humans Indigenous peoples Infectious diseases Kidney Function Tests Lipids Lipids - blood Liver - drug effects Liver - enzymology Male Middle Aged Patient outcomes Risk factors Substance Abuse, Intravenous - complications |
| title | Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study |
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