Defining multimorbidity in people with HIV – what matters most?

Abstract

Purpose of reviewAlthough multimorbidity (defined as the coexistence of multiple conditions) presents significant health challenges to people with HIV, there is currently no consensus on how it should be defined among this population. This review aimed to examine the definition of multimorbidity in existing studies among people with HIV (n = 22).Recent findingsVariation in the definition of multimorbidity (in terms of the number and nature of conditions included) across studies among people with HIV was observed, with less than half (45%) reporting a selection criteria for conditions. The number of conditions considered ranged from 4 to 65. Certain conditions (e.g. stroke, myocardial infarction and chronic kidney disease) and risk factors (e.g. hypertension) were more frequently included, while other symptoms (e.g. joint pain, peripheral neuropathy and sleeping problems) and mental health conditions (e.g. anxiety and panic attacks) were rarely included in the definition of multimorbidity.SummaryThe definition of multimorbidity among people with HIV is highly variable, with certain conditions overlooked. We propose recommendations that researchers should consider when defining multimorbidity among this population to not only enable comparisons between studies/settings but also to ensure studies consider a person-centred approach that can accurately capture multimorbidity among people with HIV.

Factors associated with poorer quality of life in people living with HIV in southwestern France in 2018–2020 (ANRS CO3 AQUIVIH-NA cohort: QuAliV study)

“…Furthermore, as our measure of multi-morbidity is a count of the most common non-communicable diseases affecting PLWH, we may have underestimated its association with poorer multidimensional QoL. Had we adopted a broader definition, encompassing rarer comorbidities, the effect sizes may have been more pronounced 24 . This finding has major implications for HIV care in years to come as an estimated 28% of PLWH will have three or more non-communicable diseases in 2030, posing a threat not only their physical QoL but their psychological, social and environmental QoL as well 22 .…”

Associations between social determinants of health and comorbidity and multimorbidity in people of black ethnicities with HIV

“…Strengths of this study include the utilization of a broad spectrum of SDH in a well characterized cohort of people of African ancestry with HIV in South London, one of the most ethnically diverse and socioeconomically deprived areas in the UK. We were able to include mental health and chronic pain in our analyses, which are often excluded as conditions or risk factors [ 80 ] and included measures of HIV-related stigma and generalized discrimination as SDH.…”

Frailty and cognition in older people with HIV: recognizing the importance of geriatric syndromes

“…Multimorbidity is increasingly recognized in OPWH [4,25]. Indeed, these investigators has recently shown that multimorbidity is associated with frailty in this same cohort [26].…”