Clusterization of co-morbidities and multi-morbidities among persons living with HIV: a cross-sectional study

Abstract

Background Among people living with HIV (PLWH), the prevalence of non-HIV related co-morbidities is increasing. Aim of the present study is to describe co-morbidity and multi-morbidity, their clustering mode and the potential disease-disease interactions in a cohort of Italian HIV patients. Methods Cross-sectional analysis conducted by the Coordinamento Italiano per lo Studio di Allergia e Infezioni da HIV (CISAI) on adult subjects attending HIV-outpatient facilities. Non-HIV co-morbidities included: cardiovascular disease, diabetes mellitus, hypertension, oncologic diseases, osteoporosis, probable case of chronic obstructive pulmonary disease (COPD), hepatitis C virus (HCV) infection, psychiatric illness, kidney disease. Multi-morbidity was defined as the presence of two or more co-morbidities. Results One thousand and eighty-seven patients were enrolled in the study (mean age 47.9 ± 10.8). One hundred-ninety patients (17.5%) had no co-morbidity, whereas 285 (26.2%) had one condition and 612 (56.3%) were multi-morbid. The most recurrent associations were: 1) dyslipidemia + hypertension (237, 21.8%); 2) dyslipidemia + COPD (188, 17.3%); 3) COPD + HCV-Ab+ (141, 12.9%). Multi-morbidity was associated with older age, higher body mass index, current and former smoking, CDC stage C and longer ART duration. Conclusions More than 50% of PLHW were multi-morbid and about 30% had three or more concurrent comorbidities. The identification of common patterns of comorbidities address the combined risks of multiple drug and disease-disease interactions.

Lipid profile changings after switching from rilpivirine/tenofovir disoproxil fumarate/emtricitabine to rilpivirine/tenofovir alafenamide/emtricitabine: Different effects in patients with or without baseline hypercholesterolemia

“…Also, the prevalence of hypercholesterolemia that we found in our study, i.e. 20%, is lower than that estimated in the Italian population of people living with HIV, where up to 50% have been reported to have dyslipidemia [18]. Thus, the study population might not be representative of the Italian population living with HIV and this further limits the generalizability of our results.…”

Comorbidity Networks in Cardiovascular Diseases

“…In fact, if the therapy recommended for one disease is contraindicated in the presence of a concurrent medical condition, the usefulness of clinical practice guidelines becomes limited. In such a scenario, evidence-based treatment guidelines, designed for single diseases, can lead to serious therapeutic conflicts (Maggi et al, 2019 ). To circumvent such limitations, a personalized approach to medicine may benefit from the inclusion of ideas from a somewhat recent field of research, generally known as systems biology or network medicine —when applied to humans.…”

Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy

“…In our study, cardiovascular disease caused 6% of hospitalizations. Oncologic disease caused 11% of hospitalizations; the malignancies in HIV Italian cohorts were observed in 8.5% of the CISAI cohort [ 12 ] and in 3.8% of the ICONA cohort [ 13 ].…”