Comorbidities Among US Patients With Prevalent HIV Infection—A Trend Analysis

Gallant, Joel E.; Hsue, Priscilla Y.; Shreay, Sanatan; Meyer, Nicole

doi:10.1093/infdis/jix518

Cited by 144 publications

(156 citation statements)

References 30 publications

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“…There is some evidence from high‐income countries that HIV and ART may increase the prevalence of NCDs . However, it is crucial to examine this question more closely in HIV endemic settings, such as sub‐Saharan Africa , where it is a question of high importance to population health.…”

Section: Introductionmentioning

confidence: 99%

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

et al. 2019

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Introduction The HIV‐infected population is growing due to the increased accessibility of antiretroviral therapy (ART) that extends the lifespan of people living with HIV (PLHIV). We aimed to assess whether national HIV prevalence and ART use are associated with an increased prevalence of cardiovascular risk factors. Methods Using country‐level data, we analysed the effect of HIV prevalence and use of ART on cardiovascular risk factors in 44 countries in sub‐Saharan Africa between 2000 and 2016. We used fixed‐effects estimation to quantify the effect of HIV and ART on the prevalence of diabetes, mean body mass index, the prevalence of overweight, obesity and hypertension, and mean systolic blood pressure. The models were adjusted for calendar time, the age structure of the population, income and education. Results Diabetes prevalence among PLHIV was 5.8 percentage points higher (95% confidence interval (CI) 1.8 pp to 9.8 pp) compared to individuals without HIV. People receiving ART had a 4.6 percentage point higher prevalence (95% CI 2.6 pp to 6.6 pp). The prevalence of obesity was increased by 14.7 percentage points (95% CI 2.5 pp to 26.9 pp) for PLHIV. Receiving ART was associated with an increased obesity prevalence by 14.0 percentage points (95% CI 4.8 pp to 23.2 pp), whereas it had no significant association with the prevalence of overweight. The population aged 40 to 59 had a significantly higher prevalence of diabetes, overweight and obesity. HIV prevalence and ART use had no significant association with the prevalence of hypertension. Conclusions An ageing HIV‐infected population on ART is associated with a significant increase in the prevalence of diabetes and obesity in sub‐Saharan Africa. The increasing prevalence of these cardiovascular risk factors emphasizes the need for comprehensive healthcare programmes that screen and treat both HIV and non‐communicable diseases to decrease the associated morbidity and mortality rates.

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Section: Introductionmentioning

confidence: 99%

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

et al. 2019

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“…The noninfectious chronic comorbidities included in the survey were diabetes, cancers, and cardiovascular disease. These chronic comorbid conditions were selected because of their high prevalence among HIV‐infected patients . Given the constraints of the length of the questionnaire, we did not specify every type of certain diseases (e.g.…”

Section: Methodsmentioning

confidence: 59%

“…The results also allow examination of regional differences in the rates of comorbid conditions. For instance, the prevalence of comorbidity with diabetes in our setting (15.2%) is lower than that in another study in a sample of HIV‐infected patients from a US national MarketScan research database (31.1%) but higher than that in the general population in the USA (8%) . Differences in characteristics of the populations may contribute to this regional disparity in comorbidity rates in the USA, and this warrants further investigation.…”

Section: Discussionmentioning

confidence: 99%

Patterns of comorbidity and sociodemographic and psychosocial correlates among people living with HIV in South Carolina, USA

Yang

Qiao

2019

HIV Medicine

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Objectives Prevention of comorbidity with HIV infection warrants more attention as people living with HIV (PLWH) tend to live longer in the era of effective antiretroviral therapy (ART). This study aimed to investigate the associations between various psychosocial variables and different comorbid conditions in South Carolina (SC), USA. Methods A cross‐sectional survey was conducted among PLWH from May to September 2018 in SC. Comorbid conditions were based on self‐report data and grouped into sexually transmitted infection (STI) comorbidities, noninfectious chronic comorbidities or any comorbidity. Multivariate logistic regression models were used to analyse the relevant associations. Results Among 402 participants, the prevalence of STI comorbidities, noninfectious chronic comorbidities, and any comorbidity was 61.7%, 21.9% and 69.4%, respectively. The multivariate analysis showed that higher depression scores were associated with an increased risk of any comorbidity, while higher anxiety scores were associated with an increased risk of STI comorbidities or any comorbidity. Higher resilience scores were associated with a decreased risk of noninfectious chronic comorbidities or any comorbidity. Conclusions The association between psychosocial factors and different types of comorbidity could inform holistic interventions, such as providing integrated mental health services (e.g. treating mental health problems or building resilience), to effectively cope with and manage the co‐existing medical conditions of PLWH.

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“…2 Comorbidities of HIV infection are common, and their prevalence has increased. [4][5][6] In particular, treating noninfectious comorbidities related to aging is becoming a major factor in the health care of people living with HIV because of the availability of effective ART, which has substantially improved the life expectancy of these individuals. 4,7,8 The proportion of adults living with HIV in the United States who have 2 or more age-associated comorbidities nearly tripled between 2000 and 2009 to 22.4%.…”

mentioning

confidence: 99%

“…4 A particular age-related comorbidity seen commonly in individuals with HIV infection is type 2 diabetes mellitus. 5,6,9 The recommended first-line therapy for most individuals with type 2 diabetes mellitus is metformin, which is an orally administered biguanide that improves glycemic control by lowering hepatic glucose production. 10,11 Although a number of agents are available for treating HIV, many have limitations, including tolerability and resistance issues.…”

mentioning

confidence: 99%

Evaluation of the Pharmacokinetics of Metformin Following Coadministration With Doravirine in Healthy Volunteers

Sánchez

Yee

et al. 2019

Clinical Pharm in Drug Dev

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Doravirine is a novel nonnucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus type-1 (HIV-1) infection. In vitro and clinical data suggest that doravirine is unlikely to cause significant drug-drug interactions via major drug-metabolizing enzymes or transporters. As a common HIV-1 infection comorbidity, type 2 diabetes mellitus is often treated with metformin. Perturbations of metformin absorption or elimination may affect its safety and efficacy profile; therefore, understanding potential drug-drug interactions between doravirine and metformin is important. An open-label, fixed-sequence, 2-period trial in healthy adults was conducted. Single-dose metformin 1000 mg was administered in period 1; in period 2, doravirine 100 mg was administered once daily on days 1 to 7, and single-dose metformin 1000 mg was administered on day 5. Plasma pharmacokinetics for metformin alone and coadministered with doravirine were assessed. Fourteen participants enrolled and completed the trial. Least-squares geometric mean ratios and 90% confidence intervals of metformin AUC 0-Ý , and C max following coadministration of metformin and doravirine compared with metformin alone were 0.94 (0.88-1.00) and 0.94 (0.86-1.03), respectively; metformin T max and half-life were also minimally impacted. These data indicate that doravirine did not have a clinically relevant effect on the pharmacokinetics of metformin. Metformin alone and coadministered with doravirine was generally well tolerated. These data support coadministration of doravirine 100 mg and metformin 1000 mg without dose adjustment.Keywords antiretroviral therapy, doravirine, drug interaction, human immunodeficiency virus (HIV), metformin, type 2 diabetes, nonnucleoside reverse transcriptase inhibitor (NNRTI), pharmacokinetics

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Comorbidities Among US Patients With Prevalent HIV Infection—A Trend Analysis

Abstract: Comorbidities are common among the aging HIV-infected population and have increased over time. There should be a consideration in treatment choices for HIV infection, including the choices of antiretroviral regimens.

Cited by 144 publications

References 30 publications

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

HIV, antiretroviral therapy and non‐communicable diseases in sub‐Saharan Africa: empirical evidence from 44 countries over the period 2000 to 2016

Patterns of comorbidity and sociodemographic and psychosocial correlates among people living with HIV in South Carolina, USA

Evaluation of the Pharmacokinetics of Metformin Following Coadministration With Doravirine in Healthy Volunteers

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