Comorbidities among the HIV-Infected Patients Aged 40 Years or Older in Taiwan

Wu, Pei‐Ying; Chen, Mao-Yuan; Hsieh, Szu‐Min; Sun, Hsin‐Yun; Tsai, Mao‐Song; Lee, Kuan-Yeh; Liu, Wen-Chun; Yang, Shan-Ping; Luo, Yi; Zhang, Junyu; Sheng, Wang-Huei; Hung, Chien‐Ching

doi:10.1371/journal.pone.0104945

Cited by 30 publications

(32 citation statements)

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“…A quarter of the patients (median age 56 years) had two prescribed co‐treatments and more than half of the patients (56.2%) had more than two co‐treatments in addition to their cART. This confirms that the aging HIV‐infected population is burdened with comorbidities, as described previously in the SHCS population and in other HIV‐positive populations . The major comorbidity in our study was cardiovascular disease.…”

Section: Discussionsupporting

confidence: 91%

HIV‐infected patients' beliefs about their chronic co‐treatments in comparison with their combined antiretroviral therapy

et al. 2017

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ObjectivesThanks to the success of combination antiretroviral therapy (cART), HIV‐infected patients can have almost a normal life expectancy. This has resulted in an aging HIV‐infected population with other chronic comorbidities such as cardiovascular diseases, osteoporosis, and depression. Our hypothesis is that patients' perceptions of and attitudes towards their cART, which is perceived as crucial to their survival, differ from their beliefs about their co‐treatments, and this may have an impact on their medication adherence.MethodsWe used the French version of the Beliefs about Medicine Questionnaire (BMQ‐f) to measure the perceptions of patients about their co‐treatments and the Beliefs about Medicine Questionnaire for Highly Active Antiretroviral Therapy (BMQ‐HAART) to measure their beliefs about their cART in a representative sample (n = 150) of patients enrolled in the Swiss HIV Cohort Study (SHCS) and followed at the Infectious Disease Service at the University Hospital in Lausanne, Switzerland. The survey was administered to all eligible patients by the order of their scheduled appointments at the end of their medical visit. The BMQ comprises two subscores: Specific‐Necessity (5 identical items in BMQ‐f and BMQ‐HAART) and Specific‐Concerns (also 5 identical items in BMQ‐f and BMQ‐HAART). The subscores were standardized by dividing the score scale by the number of questions in the scale, resulting in a range of responses between 1 (low) and 5 (high). Self‐reported medication adherence was measured using the SHCS Adherence Questionnaire (SHCS‐AQ). Adherence was defined as not missing any dose or missing one dose of the treatment in the past 4 weeks. Sociodemographic variables were retrieved by reviewing the SHCS database.ResultsA response rate of 73% (109 of 150) was achieved. A total of 105 patients were included in the analysis: their median age was 56 [interquartile range (IQR) 51, 63] years and 74 were male (70%). Eighty‐seven patients (83%) were adherent to cART and 75 (71%) were adherent to their co‐treatments (P = 0.0001). The standardized mean responses for the BMQ Specific‐Necessity subscores were 4.46 [standard deviation (SD): 0.58] and 2.86 (SD: 1.02) for cART and co‐treatments, respectively (P < 0.0001). For Specific‐Concerns, the standardized mean responses were 2.9 (SD: 1.02) for cART and 4.09 (SD: 1.02) (P < 0.0001) for co‐treatments. cART and co‐treatment concerns increased as the number of co‐treatments increased (P = 0.03 and P < 0.0001, respectively).ConclusionsPatients had higher Necessity and lower Concerns scores for their cART in comparison with their co‐treatments. A higher percentage of patients reported being adherent to cART compared with the co‐treatments that they reported they were most likely to miss. Further research using a bigger sample size and more objective measures of adherence is needed to explore the association between adherence and patients' perceptions.

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Section: Discussionsupporting

confidence: 91%

HIV‐infected patients' beliefs about their chronic co‐treatments in comparison with their combined antiretroviral therapy

et al. 2017

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“…Several studies have provided evidence that PLWHIV with ageing-associated comorbidities may require additional pharmacologic interventions that can complicate therapeutic management [24][25][26][27]. Consistent with findings reported in the literature [9,22,28,29] older PLWHIV are taking more medications to treat comorbidities than younger PLWHIV, or similarly-aged HIV-uninfected patients.…”

Section: Resultssupporting

confidence: 60%

Healthcare Resources Use in Patients with Human Immunodeficiency Virus (HIV). Real-World Evidence From Six Italian Local Health Units

Perrone

Sangiorgi

Buda

et al. 2018

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AIM: The aim of the study was to evaluate healthcare resource use and related costs for the management of people living with Human Immunodeficiency Virus (PLWHIV) with and without comorbidities, and to compare the burden of comorbidities in PLWHIV to the general population.METHODS: An observational retrospective analysis, based on administrative and laboratory databases from 6 Italian Local Health Units (LHUs) was performed. Individuals receiving either an HIV treatment [Antiretroviral therapy (ART) – ATC code: J05A)], or with an HIV positive laboratory test result between January 1st, 2014 and December 31st, 2014 were included. The date of first ART prescription or positive test of HIV was used as the Index Date (ID). Patients enrolled were followed-up for all time available from the ID (follow-up period) and their clinical characteristics were investigated from one year prior to the ID (characterization period). Comorbidities were measured by using the Charlson Comorbidity Index; findings were compared with those of a sample of the general population with the same age and sex distribution (OsMed 2015). Healthcare resource use and related cost was evaluated during the follow-up period.RESULTS: 1,214 patients were included, 837 were PLWHIV without any comorbidities and 377 were PLWHIV with at least one comorbidity. Mean prevalence of prescriptions for treatment of comorbidities was higher in the HIV-infected population than in the Italian general population. The annual healthcare cost of managing HIV patients with comorbidities, was significantly higher than that for patients without comorbidities (€ 10,615 vs. € 8,665, p < 0.001).CONCLUSIONS: Study results showed that 30% of PLWHIV had at least one comorbidity. The cost of managing PLWHIV who have comorbidities was significantly higher than that of managing PLWHIV without comorbidities. Our data confirm that care and treatment services should be adapted to address the specific needs of people living with both HIV and comorbidities.

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“…In this study, it was found that the vast majority (90%) of HIV-1infected patients aged 50 years and older had at least one NARC. This prevalence is particularly high when compared to cohort and cross-sectional studies from other regions, which have reported one or more NARC in 50-70% of older HIV patients (Hasse et al, 2011;Rodriguez-Penney et al, 2013;Torres et al, 2013;Wu et al, 2014). However, two surveys conducted in the USA showed a prevalence of NARC over 90% (Brennan, 2009;Balderson et al, 2013).…”

Section: Discussionmentioning

confidence: 91%

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study

Serrão

Piñero

Vélez

et al. 2019

International Journal of Infectious Diseases

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To characterize the profile of non-AIDS-related comorbidities (NARC) in the older HIV-1infected population and to explore the factors associated with multiple NARC. Methods: This was a multicentre, cross-sectional study including HIV-1-infected patients aged !50 years, who were virologically suppressed and had been on a stable antiretroviral therapy (ART) regimen for at least 6 months. A multiple regression model explored the association between demographic and clinical variables and the number of NARC. Results: Overall, 401 patients were enrolled. The mean age of the patients was 59.3 years and 72.6% were male. The mean duration of HIV-1 infection was 12.0 years and the median exposure to ART was 10.0 years. The mean number of NARC was 2.1, and 34.7% of patients had three or more NARC. Hypercholesterolemia was the most frequent NARC (60.8%), followed by arterial hypertension (39.7%) and chronic depression/anxiety (23.9%). Arterial hypertension and diabetes mellitus were the most frequently treated NARC (95.6% and 92.6% of cases, respectively). The linear regression analysis showed a positive relationship between age and NARC (B = 0.032, 95% confidence interval 0.015-0.049; p = 0.0003) and between the duration of HIV-1 infection and NARC (B = 0.039, 95% confidence interval 0.017-0.059; p = 0.0005). Conclusions: A high prevalence of NARC was found, the most common being metabolic, cardiovascular, and psychological conditions. NARC rates were similar to those reported for the general population, suggesting a larger societal problem beyond HIV infection. A multidisciplinary approach is essential to reduce the burden of complex multi-morbid conditions in the HIV-1-infected population.

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Comorbidities among the HIV-Infected Patients Aged 40 Years or Older in Taiwan

Cited by 30 publications

References 46 publications

HIV‐infected patients' beliefs about their chronic co‐treatments in comparison with their combined antiretroviral therapy

HIV‐infected patients' beliefs about their chronic co‐treatments in comparison with their combined antiretroviral therapy

Healthcare Resources Use in Patients with Human Immunodeficiency Virus (HIV). Real-World Evidence From Six Italian Local Health Units

Non-AIDS-related comorbidities in people living with HIV-1 aged 50 years and older: The AGING POSITIVE study

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