The changing patterns of comorbidities associated with human immunodeficiency virus infection, a longitudinal retrospective cohort study of Medicare patients

Abstract

The objective of this paper is to determine the temporal trend of the association of 66 comorbidities with human immunodeficiency virus (HIV) infection status among Medicare beneficiaries from 2000 through 2016. We harvested patient level encounter claims from a 17-year long 100% sample of Medicare records. We used the chronic conditions warehouse comorbidity flags to determine HIV infection status and presence of comorbidities. We prepared 1 data set per year for analysis. Our 17 study data sets are retrospective annualized patient level case histories where the comorbidity status reflects if the patient has ever met the comorbidity case definition from the start of the study to the analysis year. We implemented one logistic binary regression model per study year to discover the maximum likelihood estimate (MLE) of a comorbidity belonging to our binary classes of HIV+ or HIV– study populations. We report MLE and odds ratios by comorbidity and year. Of the 66 assessed comorbidities, 35 remained associated with HIV– across all model years, 19 remained associated with HIV+ across all model years. Three comorbidities changed association from HIV+ to HIV– and 9 comorbidities changed association from HIV– to HIV+. The prevalence of comorbidities associated with HIV infection changed over time due to clinical, social, and epidemiological reasons. Comorbidity surveillance can provide important insights into the understanding and management of HIV infection and its consequences.

Factors Related to Multidimensional Frailty Among Hispanic People Living With HIV Aged 50 Years and Above: A Cross-sectional Study

“…Hypertension, diabetes mellitus, and depression or mood disorders were the most frequently reported comorbidities in our study. In previous epidemiological studies conducted among PLWH in the United States, many of these comorbid conditions were also reported, underscoring the relevance of understanding and managing HIV and its consequences (Gallant et al, 2017;Williams et al, 2021). Similar to our results, another study reported that frailty among older PLWH is characterized by hypertension, diabetes mellitus, hyperlipidemia, and polypharmacy, all of which may result in metabolic syndrome (McMillan et al, 2020).…”

Altered adipose tissue macrophage populations in people with HIV on integrase inhibitor-containing ART

“…PWH are at increased risk for metabolic dysfunction and disease [ 3 – 5 ]. It is therefore important that we improve our understanding of the etiology of these comorbidities to reduce morbidity and mortality in this population [ 6 ].…”

“…The life expectancy of people with HIV (PWH) has increased considerably due to the development of effective antiretroviral therapy (ART) over the past several decades [ 1 , 2 ]. However, PWH are at increased risk for several chronic, noninfectious comorbidities including obesity, dyslipidemia, diabetes mellitus, and cardiovascular disease [ 3 – 5 ]. As a result, metabolic and cardiovascular diseases are now some of the leading causes of death among PWH in developed countries [ 6 ].…”

Does smoking cessation reduce other substance use, psychiatric symptoms, and pain symptoms? Results from an emulated hypothetical randomized trial of US veterans

“…PLHIV have greater risk for various mental and physical comorbidities in addition to conditions discussed in the current study [ 44 , 45 ] and are more likely to engage in polypharmacy [ 46 ]. Therefore, this subpopulation may have unique differential effects of tobacco cessation on improvements in co-occurring conditions.…”