Infectious Disease

The prevalence of multimorbidity is rising in older individuals with HIV

December 27, 2020

2 min read

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Arant does not report any relevant financial information. In the study you will find all relevant financial information from all other authors.

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The prevalence of multimorbidity increased from 2006 to 2016 in older adults with HIV who attended a Ryan White HIV / AIDS program clinic, according to a study published in the Open Forum Infectious Diseases.

“While AIDS-related morbidity and mortality have decreased, age-related chronic diseases such as cardiovascular disease, renal dysfunction, diabetes, non-AIDS-defining malignancies and osteoporosis in people with HIV (PLWH) are becoming more common. , ” Elisabeth C. Arant, MD, Fellow physician in the Infectious Disease Department at the University of North Carolina at Chapel Hill, Healio said.

Microscopic HIV gray

The prevalence of multimorbidity increased from 2006 to 2016 among older adults with HIV who attended a Ryan White HIV / AIDS program.

“There is evidence that multimorbidity or the accumulation of multiple serious chronic diseases may be higher in PLWH. We were interested in comparing the prevalence of multimorbidity between two different cohorts of older people with HIV in a clinic in the southeast Ryan White HIV / AIDS Program (RWHAP) – one cohort from 2006 and one from 2016. “

According to the study, the cohorts included PLWH ages 45 to 89 with more than one medical visit to a RWHAP Southeastern HIV clinic in 2006 (cohort 1) or 2016 (cohort 2). The researchers evaluated the data on associations between traits and multimorbidity, which were defined as more than two chronic diseases, including hypertension, obesity, type 2 diabetes, hypercholesterolemia, cardiovascular disease, chronic kidney disease, osteopenia and osteoporosis, chronic obstructive Lung disease and end-stage liver disease and non-AIDS-related malignancy and HIV outcomes.

The study found that multimorbidity increased from cohort 1 (n = 149; 12.8%) to cohort 2 (n = 323; 29.7%). The researchers found that private insurance was associated with lower multimorbidity than Medicare (Cohort 1: aOR = 0.15; 95% CI, 0.02-0.63; Cohort 2: aOR = 0.53; 95% CI , 0.27-1). In people in Cohort 2, the researchers found that multimorbidity was associated with the female gender (aOR = 2.57; 95% CI, 1.22-5.58) and that participants who lived in rural areas compared to those who lived were more often cared for in urban areas (aOR = 1.23; 95% CI, 1.10-1.38). Among the participants in cohort 1, black participants were less likely to be cared for than non-black participants (aOR = 0.72; 95% CI, 0.61–0.87). In addition, the researchers found that multimorbidity was not associated with differences in HIV outcomes.

“Given the lower multimorbidity rate among privately insured individuals, RHWAP should consider a targeted investment to ensure more preventive care in RWHAP clinics with the aim of reducing the multimorbidity prevalence in PLWH. The higher rate of multimorbidity among women in the aging PLWH population should be further explored, ”said Arant. “Older women living with HIV may need more targeted approaches to preventing and treating chronic diseases. While there is a federal plan to end the HIV epidemic in place, the US and RHWAP must continue to prevent, diagnose and treat the comorbidities of PLWH to ensure that PLWH continues to thrive. “

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