TY - JOUR
T1 - Changing co-morbidity and increasing deprivation among people living with HIV
T2 - UK population-based cross-sectional study
AU - McGettigan, Patricia
AU - Morales, Daniel R.
AU - Moreno-Martos, David
AU - Matin, Nashaba
N1 - Funding Information:
We thank Barts Charity for funding support to conduct this study. We thank the patients and general practitioners who support medical research and public health through the anonymous use of their electronic health records and the CPRD Operations Coordinators who facilitated data access. We would also like to thank Megan McMinn and the University of Dundee's Health Informatics Centre for help in preparing the code list of comorbidities.
Publisher Copyright:
© 2022 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.
PY - 2022/9/19
Y1 - 2022/9/19
N2 - Background: The great success of HIV treatments means that, increasingly, people living with HIV (PLHIV) are growing old enough to develop age-associated comorbid conditions. We investigated the evolution of comorbid conditions and demographics among PLHIV in England.Methods: In a cross-sectional study linking Clinical Practice Research Datalink (CPRD) primary care, hospitalization, death registry and Index of Multiple Deprivation data, we measured the prevalence of 304 individual health conditions, categorized into 47 condition groups (36 non-communicable, 11 communicable). Using logistic regression, we calculated odds ratios (ORs) for the likelihood of each condition and condition group in 2015 versus 2008, adjusting for age, sex and deprivation.Results: In 2015, there were 964 CPRD-registered PLHIV compared with 1987 in 2008; 62% were male and 38% female in both cohorts. The 2015 cohort was older, with 51.1% aged 45–64 years and 7.2% aged 65–84 years compared with 31.8% and 3.2%, respectively, in 2008. Deprivation was higher in 2015, at 23.9% (quintile 4) and 28.7% (quintile 5) compared with 5.8% and 6.6%, respectively, in 2008. Of 36 non-communicable condition groups, 14 (39%) occurred in ≥ 10% of PLHIV in 2015, of which seven were more likely in 2015 than in 2008: renal-chronic-kidney-disease [odds ratio (OR) = 1.96 (95% CI: 1.33–2.90); endocrine-obesity [OR = 1.76 (1.12–2.77)]; rheumatology [OR = 1.64 (1.30–2.07)]; dermatology [OR = 1.55(1.29–1.85)]; genito-urinary-gynaecological [OR = 1.44(1.18–1.76)]; eyes-ears/nose/throat [OR = 1.31(1.08–1.59)]; and gastro-intestinal conditions [OR = 1.28 (1.04–1.58)]. Two condition groups, respiratory-chronic-obstructive-pulmonary-disease [OR = 0.36 (0.19–0.69)] and endocrine-diabetes [OR = 0.49 (0.34–0.70)], were less likely in 2015. Ten out of 11 communicable infectious condition groups were less likely in 2015.Conclusions: Although infections in PLHIV have fallen, chronic non-communicable comorbidity is increasingly prevalent. Alongside the marked increases in deprivation and ageing, this study suggests that socio-economic measures in addition to healthcare provision are needed to achieve holistic health for PLHIV.
AB - Background: The great success of HIV treatments means that, increasingly, people living with HIV (PLHIV) are growing old enough to develop age-associated comorbid conditions. We investigated the evolution of comorbid conditions and demographics among PLHIV in England.Methods: In a cross-sectional study linking Clinical Practice Research Datalink (CPRD) primary care, hospitalization, death registry and Index of Multiple Deprivation data, we measured the prevalence of 304 individual health conditions, categorized into 47 condition groups (36 non-communicable, 11 communicable). Using logistic regression, we calculated odds ratios (ORs) for the likelihood of each condition and condition group in 2015 versus 2008, adjusting for age, sex and deprivation.Results: In 2015, there were 964 CPRD-registered PLHIV compared with 1987 in 2008; 62% were male and 38% female in both cohorts. The 2015 cohort was older, with 51.1% aged 45–64 years and 7.2% aged 65–84 years compared with 31.8% and 3.2%, respectively, in 2008. Deprivation was higher in 2015, at 23.9% (quintile 4) and 28.7% (quintile 5) compared with 5.8% and 6.6%, respectively, in 2008. Of 36 non-communicable condition groups, 14 (39%) occurred in ≥ 10% of PLHIV in 2015, of which seven were more likely in 2015 than in 2008: renal-chronic-kidney-disease [odds ratio (OR) = 1.96 (95% CI: 1.33–2.90); endocrine-obesity [OR = 1.76 (1.12–2.77)]; rheumatology [OR = 1.64 (1.30–2.07)]; dermatology [OR = 1.55(1.29–1.85)]; genito-urinary-gynaecological [OR = 1.44(1.18–1.76)]; eyes-ears/nose/throat [OR = 1.31(1.08–1.59)]; and gastro-intestinal conditions [OR = 1.28 (1.04–1.58)]. Two condition groups, respiratory-chronic-obstructive-pulmonary-disease [OR = 0.36 (0.19–0.69)] and endocrine-diabetes [OR = 0.49 (0.34–0.70)], were less likely in 2015. Ten out of 11 communicable infectious condition groups were less likely in 2015.Conclusions: Although infections in PLHIV have fallen, chronic non-communicable comorbidity is increasingly prevalent. Alongside the marked increases in deprivation and ageing, this study suggests that socio-economic measures in addition to healthcare provision are needed to achieve holistic health for PLHIV.
KW - communicable conditions
KW - comorbid conditions
KW - deprivation
KW - HIV care provision
KW - non-communicable conditions
KW - people living with HIV (PLHIV)
UR - http://www.scopus.com/inward/record.url?scp=85138307912&partnerID=8YFLogxK
U2 - 10.1111/hiv.13389
DO - 10.1111/hiv.13389
M3 - Article
C2 - 36123816
AN - SCOPUS:85138307912
JO - HIV Medicine
JF - HIV Medicine
SN - 1464-2662
ER -
