The burden of chronic diseases and cost-of-care in subjects with HIV infection in a Health District of Northern Italy over a 12-year period compared to that of the general population

Quiros-Roldan, Eugenia; Magoni, Michele; Raffetti, Elena; Donato, Francesco; Scarcella, Carmelo; Paraninfo, Giuseppe; Castelli, Francesco

doi:10.1186/s12889-016-3804-4

Cited by 20 publications

(38 citation statements)

References 32 publications

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“…These data are consistent with the results of previous studies [14,22,32,33], suggesting that the increasing life expectancy, and the higher prevalence of chronic complications in ageing HIV populations play an important role in healthcare costs for HIV management. In addition, our data highlights that the costs associated with HIV-related hospitalizations were higher in PLWHIV with comorbidities than patients without comorbidities.…”

Section: Resultssupporting

confidence: 92%

“…In addition, our data highlights that the costs associated with HIV-related hospitalizations were higher in PLWHIV with comorbidities than patients without comorbidities. A recent Italian [20,23,32,33]. Indeed, comorbidity increases with HIV severity, and the greater prevalence of comorbidities among people living with HIV/AIDS may be attributed to antiretroviral toxicity (diabetes, vascular disease and liver disease) or caused by the HIV infection itself (vascular, pulmonary and renal diseases) [23].…”

Section: Resultsmentioning

confidence: 99%

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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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Section: Resultssupporting

confidence: 92%

Section: Resultsmentioning

confidence: 99%

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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“…Although it is still an incurable disease, thanks to antiretroviral therapy, HIV infection does not represent a deadly disease, but a chronic infection with which the patients live even in the case of the presence of viral resistance. Antiretroviral therapy leads to suppression of viral replication and so improves and maintains the function of the immune system, thereby reducing the risk of developing AIDS-associated diseases, as well as other complications (6,7). It is known that the antiretroviral therapy has numerous side effects such as lipodystrophy, gastrointestinal disorders, metabolic disorders, insulin resistance and dyslipidemia, as indicated by our results.…”

Section: Discussionsupporting

confidence: 58%

Risk assessment for the development of metabolic syndrome in patients with AIDS, after the first year of antiretroviral therapy

Pejković¹,

Stojic²,

Jovicić³

2019

Medicinski podmladak

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Introduction: Antiretroviral therapy (ART) in the treatment of HIV infection has allowed maximum control of viral replication and reconstruction of the immune system, which has contributed to the long-term survival. However, it has been observed that a long-term use of ART can lead to cumulative toxicity and metabolic abnormalities. Aim: The aim of this study was to determine whether there is a difference in lipidogram, glycemia and body mass index (BMI) before and after the initiation of ART, and to determine in which of the antiretroviral drugs the changes in the values of the measured variables were most common. Material and methods: The research was conducted at the Clinic for Infectious Diseases, Clinical Center of Kragujevac, as a prospective study involving 40 patients diagnosed with HIV infection. Biochemical parameters and BMI calculation were performed before the initiation of ART and one year after. Results: The analysis of the observed variables indicated a statistically significant difference in total cholesterol (p = 0.001), HDL (p = 0.002), LDL (p = 0.003), triglycerides (p < 0.001), glucose (p < 0.001) and BMI (p = 0.002). By analyzing the administered АRT therapy, statistical significance was achieved in the measured triglyceride values after the administration of ritonavir and lopinavir, while the highest BMI values, compared to initial ones, were observed after the administration of ritonavir, but without achieving statistical significance. Conclusion:The results of the study showed that АRТ therapy has effect on the development of hyperlipidemia, which may be associated with an increased risk of developing cardiovascular disease and protease inhibitors of the older generation are highlighted, in particular. АRT therapy in HIV-infected cells contributes to the development of a metabolic syndrome involving dyslipidemia, lipodystrophy and insulin resistance.Uvod: Antiretrovirusna terapija u lečenju infekcije virusa humane imunodeficijencije (HIV) omogućila je maksimalnu kontrolu virusne replikacije i rekonstrukciju imunog sistema, što je doprinelo dužem preživljavanju, čak i kod bolesnika sa uznapredovalom bolešću. Uočeno je, ipak, da dugotrajna primena antiretrovirusne terapije može dovesti do kumulativne toksičnosti i razvoja metaboličkih abnormalnosti. Cilj: Cilj istraživanja je bio da utvrdimo da li postoji razlika u izmerenim vrednostima lipidograma, glikemije i indeksa telesne mase pre i nakon započinjanja antiretrovirusne terapije, kao i da utvrdimo kod kojih se antiretrovirusnih lekova najčešće javljaju promene u vrednostima izmerenih varijabli. Materijal i metode: Istraživanje je sprovedeno u Kliničkom centru Kragujevac, Klinika za infektivne bolesti, u vidu prospektivne studije u kojoj je učestvovalo 40 bolesnika, kod kojih je dijagnostikovana HIV infekcija. Biohemijski parametri i izračunavanje indeksa telesne mase vršeni su pre i godinu dana nakon započetog lečenja antiretrovirusnom terapijom. Podaci su statistički obrađeni u statističkom programu SPSS (verzija 22.0). Rezultati: Anali...

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“…The estimated number of infections avoided was calculated by recalculating the annual number of new HIV diagnoses from the (7) (#PIMF) year+1 = (#PIMF) year + (#ND) year (% FU) − (#PIMF) year + (#ND) year (% death) year (retention) (8) population at risk = (#ND) 100 HIV acquisition rate…”

Section: Prepmentioning

confidence: 99%

“…The lack of control of the epidemic leads to an increasing economic burden related to the management of a continuously increasing number of HIV patients. A significant part of this economic burden is associated with the long-term pharmaceutical management of these patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

Health and budget impact of combined HIV prevention – first results of the BELHIVPREV model

Vermeersch¹,

Callens

Wit

et al. 2017

Acta Clinica Belgica

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Objectives: We developed a pragmatic modelling approach to estimate the impact of treatment as prevention (TasP); outreach testing strategies; and pre-exposure prophylaxis (PrEP) on the epidemiology of HIV and its associated pharmaceutical expenses. Methods: Our model estimates the incremental health (in terms of new HIV diagnoses) and budget impact of two prevention scenarios (outreach+TasP and outreach+TasP+PrEP) against a 'no additional prevention' scenario. Model parameters were estimated from reported Belgian epidemiology and literature data. The analysis was performed from a healthcare payer perspective with a 15-year-time horizon. It considers subpopulation differences, HIV infections diagnosed in Belgium having occurred prior to migration, and the effects of an ageing HIV population. Results: Without additional prevention measures, the annual number of new HIV diagnoses rises to over 1350 new diagnoses in 2030 as compared to baseline, resulting in a budget expenditure of €260.5 million. Implementation of outreach+TasP and outreach+TasP+PrEP results in a decrease in the number of new HIV diagnoses to 865 and 663 per year, respectively. Respective budget impacts decrease by €20.6 million and €33.7 million. Conclusion: Foregoing additional investments in prevention is not an option. An approach combining TasP, outreach and PrEP is most effective in reducing the number of new HIV diagnoses and the HIV treatment budget. Our model is the first pragmatic HIV model in Belgium estimating the consequences of a combined preventive approach on the HIV epidemiology and its economic burden assuming other prevention efforts such as condom use and harm reduction strategies remain the same.

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The burden of chronic diseases and cost-of-care in subjects with HIV infection in a Health District of Northern Italy over a 12-year period compared to that of the general population

Cited by 20 publications

References 32 publications

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

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

Risk assessment for the development of metabolic syndrome in patients with AIDS, after the first year of antiretroviral therapy

Health and budget impact of combined HIV prevention – first results of the BELHIVPREV model

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