Racial disparities in the occurrence of DM, CKD, and HTN emphasize the need for prevention and treatment options for these HIV populations receiving care in North America.
Background
We sought to understand whether people living with HIV (PLHIV) ever on highly active antiretroviral therapy (HAART) follow a pattern where morbidity is compressed into the last years of life or lessened as people age. Our objective was to estimate Health Adjusted Life Expectancy (HALE) among adults living with and without HIV, and examine dependency between causes of comorbidities.
Methods
In this retrospective, population-based cohort study, the prevalence of select comorbidities was determined by age and sex using case-finding algorithms. Deaths were obtained from a vital event registry. Comorbid-specific HALE was estimated from 20 years of age by HIV status and sex. For each comorbidity, a healthy state was defined as the proportion of life expectancy comorbid-free, and was adjusted on the probability of occurrence of other different comorbidities. Lastly, the sensitivity of HALE estimates in our study was assessed to the sequencing of select comorbidities for the dependent comorbidity adjustments.
Findings
Our sample consisted electronic health records from 9,310 HIV-infected and 510,313 uninfected adults over the period 1 April 1996 to 31 December 2012 in British Columbia (BC), Canada. These individuals contributed a total of 49,605 deaths and 5,576,841 person-years over the study period. At exact age 20 years, HALE was approximately 31 years among men living with HIV and 27 years among women living with HIV. In the HIV-negative population, HALE was around 58 years for men and 63 for women. These results appear independent of ordering. However, PLHIV, particularly women living with HIV, had much shorter overall life expectancies than their HIV-negative counterparts in the general population, and thus spent less time in a healthy state.
Interpretation
While we observed limited differences in the levels of morbidity compression by HIV status, PLHIV – especially women living with HIV – spent less time in a healthy state. Expanded service delivery interventions to address complex care needs of aging PLHIV are critical to addressing shorter life expectancies, and improving their healthy states.
Funding
Canadian Institutes of Health Research.
Wildfire is closely associated with human society and having its effect on earth as well as on its environment for more than 350 million years. It is a very common phenomenon from the ancient period, has hazardous effects on both environment and human life. This study mainly focuses on the review of wildfire of Australia during 2019-2020 regarding its distribution, status of fatality influences on different environmental factors, consequences and some proposals for its mitigation. In this review paper, a modified edition of the principled review methodology was followed in compiling the most reliable data to support the bushfire in Australia belonging to its causes of occurrences and impacts. The bushfire was started in mid-June in 2019, and it is still now burning in hundreds of places of different parts of Australia, and the forest of New South Wales, Northern Territory, Western Australia, Queensland and Victoria were being burnt deadly. The accumulating data exposed the year 2019 as the driest and warmest year with lowest rainfall that might be the potential causes of bushfires in Australia. Moreover, maximum forest land of Australia is covered by naturally grown Eucalyptus trees which are generally flammable and supply oil type fuel during bushfires. Bushfire deteriorates the quality of soil, water and air of the locality up to many hundreds or thousands of kilometers away in increasing the emission of toxic substances and carbon rate. Around more than 3 billion native vertebrates, 143 million mammals, 2.46 billion reptiles, 181 million birds, 51 million frogs were burnt out by bushfires of 2020 in Australia.
Using data from the Comparison of Outcomes and Service Utilization Trends (COAST) study we examined factors associated with mood disorder diagnosis (MDD) among people living with HIV (PLHIV) and HIV-negative individuals in British Columbia, Canada. MDD cases were identified between 1998 and 2012 using International Classification of Disease 9 and 10 codes. A total of 491,796 individuals were included and 1552 (23.7%) and 60,097 (12.4%) cases of MDD were identified among the HIV-positive and HIV-negative populations, respectively. Results showed HIV status was associated with greater odds of MDD among men and lower odds among women. Among PLHIV, MDD was significantly associated with: identifying as gay, bisexual or other men who have sex with men compared to heterosexuals; higher viral load; history of injection drug use; and concurrent anxiety, dysthymia, and substance use disorders. Findings highlight the need for comprehensive and holistic HIV and mental health care.
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