<p>Comorbidities in a sample of adults with HIV in Puerto Rico: an exploratory study</p>

Abstract

Background Puerto Rico is among the areas with the highest estimated rates of people living with HIV in the United States. Despite the epidemiologic data available, there is limited real-world information that can help understand the comorbidities of people with HIV. In this study, we describe common comorbidities among adults with HIV attending treatment clinics in Puerto Rico. Methods An exploratory, retrospective, cross-sectional study was conducted at five HIV clinics in Puerto Rico. A random sample of medical records was reviewed. Descriptive statistics were used to summarize patient demographics, morbidity, and clinical characteristics. Multivariate analyses were conducted to explore comorbidities by age and sex. Results A total of 250 (179 men; 71 women) medical records were reviewed. Participants’ mean age was 47.9 years and on average they had been living with HIV for 9 years. Most (97.6%) had at least one comorbidity. The most common comorbidities were dyslipidemia and hypertension. Men were more likely to have been diagnosed with alcohol misuse while women were more likely to have been diagnosed with obesity, human papillomavirus (HPV), hypothyroidism, and osteoporosis. Participants younger than 50 years of age were more likely to have history of alcohol misuse while older individuals (50 years and old) were more likely to have been diagnosed with dyslipidemia, hypertension, and diabetes. Adjusting by sex and age, women were more likely to have been diagnosed with obesity and depression and those older than 50 years were more likely to have had a diagnosis of dyslipidemia, hypertension, HPV, and diabetes. Conclusions This is one of the few studies assessing comorbidities among adults with HIV in Puerto Rico, among Latino/Hispanics within the United States, and Latin America. Consistent with other studies, cardiovascular diseases are common among adults with HIV in Puerto Rico. Findings support the need for awareness and real-world evidence about comorbidities among people with HIV when implementing screenings and prescribing drugs.

Latinxs with HIV: Depressive Cognitive Alterations as a Precursor to Cardio-Motor Deficits

“…Another analysis by Rodriguez-Diaz et al, [16] reported that 19.2% of Puerto Ricans with HIV aged 50 and above also have depression. These figures for Latinxs with depression, along with the surge of depression in HIV-infected individuals, align with our findings as the average age of our subjects was 53 years, and 24.3% were diagnosed with the mental health disorder.…”

“…While ART has indisputable benefits, it does not prevent the development of comorbidities and disruptions often seen in those infected with HIV, such as cardiovascular, motor, and cognitive alterations [16]; in ART-treated individuals, the progression of their cognitive system disruption as a result of HIV is slowed, but cannot be aggregately prevented [15]. As is the case with diminishing cognition, motor and gait changes are also intransigent and pervasive in those with HIV, comprising a wide range of manifestations including the reduction or cumulative loss of fine motor skills, balance, and locomotion, as well as the induction of unsteady and slow gait, hyperreflexia, and bradykinesia [17].…”

“…In fact, ARTs often exacerbate the prominence of comorbidities in people receiving treatment for HIV due to prolonged life expectancies with infection-related susceptibilities [31]. It has been found that over 97% of Latinxs diagnosed with HIV have at least one comorbidity, the most common of which relates to the cardiovascular system, including heart disease, hypertension, hyperlipidemia, and impairments in cardiac mechanics, as well as diabetes and smoking, all of which can cause vascular cognitive impairments [16,32]. As such, we aim to discern the impact of depression on the gait and cardiovascular profiles in the HIV-infected Latinx population; therefore, we ask, do depressioninduced cognitive alterations affect cardio-motor components in Latinxs living with HIV?.…”

Hepatitis C care among people with HIV in Puerto Rico: A mixed-methods study

“…10 PR experiences a syndemic of overdoses with opiates, HIV, and HCV, 11,12 and, overall, policies to curb the HCV epidemic in the archipelago are lacking. 13,14,15,16 In clinic-based samples of people with HIV, it has been documented that 13.2% have also received a diagnosis of chronic Hepatitis C. 17 Further, while treatment and cure for HCV are available, the knowledge about access to, retention in, and success of care for people with HIV and HCV coinfection is limited. 18 People with HIV and HCV coinfection may have a faster disease progression that requires better-articulated interventions.…”

VIH, dislipidemias y perspectivas de su evolución

“…En un estudio en Puerto Rico, donde se revisaron un total de 250 (179 hombres; 71 mujeres) registros médicos, con un edad media de los participantes de 47.9 años y, en promedio, habiendo estado viviendo con el VIH durante 9 años, la mayoría (97.6%) tenía al menos una comorbilidad, siendo la dislipidemia e hipertensión las más comunes(30).…”