The evolving burden of HIV infection compared with other chronic diseases in northern Italy*

Magoni, Michele; Scarcella, Carmelo; Vassallo, F; Lonati, Fulvio; Carosi, Giampiero; Crea, Filippo; Quiros-Roldan, Eugenia; Albini, Laura; Gennaro, Nicola; Bishai, David; Tramarin, Andrea; Torti, Carlo

doi:10.1111/j.1468-1293.2010.00861.x

Cited by 19 publications

(21 citation statements)

References 10 publications

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“…HIV infection was identified using the following two sources, as previously described [10]:Brescia LHA electronic database. HIV diagnosis was based on HIV-related opportunistic illness requiring hospital admission (ICD9 = 042 or V08 diagnoses), receiving HIV drugs prescription or HIV reimbursement code assigned by the general practitioner or a specialist.…”

Section: Methodsmentioning

confidence: 99%

“…The Brescia Local Health Agency database (BLHADB) is a comprehensive and integrated information system including several databases tracking and listing all the health services provided by the NHS for each individual of the resident population [10]. …”

Section: Methodsmentioning

confidence: 99%

“…In our previous population-based study performed in a province of North Italy with high HIV prevalence, HIV infection ranked third among chronic diseases in order of total cost per patient to the National Health Service, with a mean cost of 9 894€ in 2007 (ranging from 8 104€ for HIV–infected patients without comorbidities to 12 013€ for HIV infection plus cancer) [10]. However, an update of the estimates of cost-of-care of HIV + subjects is needed because of recent changes of HIV epidemiologic pattern and guidelines of treatment, which have moved toward treating HIV + patients earlier in the course of disease and have added newer, more effective and tolerated but also more expensive drugs [11].…”

Section: Introductionmentioning

confidence: 99%

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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

Quiros-Roldan

Magoni²,

Raffetti

et al. 2016

BMC Public Health

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BackgroundThe increase in life expectancy of HIV-infected patients has driven increased costs due to life-long HIV treatment and concurrent age-related comorbidities. This population-based study aimed to investigate the burden of chronic diseases and health costs for HIV+ subjects compared to the general population living in Brescia Local health Agency (LHA) over a 12-year period.MethodsLHA database recorded diagnoses, deaths, drug prescriptions and health resource utilization for all residents during 2003–2014. We estimated HIV prevalence and incidence, HIV-related mortality as well as prevalence of chronic diseases in HIV+ subjects. Observed/expected ratio of chronic diseases was calculated by indirect standardization with the general population as reference. Direct cost of HIV care and determinants were estimates across the period.ResultsHIV prevalence increased from 220 to 307 per 100 000 person-years while incidence decreased from 16.1 to 10.8 per 100 000 person-years from 2003 to 2014. Prevalence of most comorbidities increased over time but it reduced significantly (annual mean change − 0.7 %) when adjusting for age and gender. Observed to expected ratio for each chronic disease in HIV+ subjects decreased over time. Cost of HIV+ cures increased (+25 %) mainly due to cost for drugs (+50 %) but it stabilized in recent years. CD4+ cell count at the time of diagnosis was an important predictor of cost for HIV management.ConclusionsExpenditures for HIV-infection are driven mainly by drugs cost and they have increased overtime. However, our findings suggest that spending on public health for HIV care can improve prognosis of HIV-infected patients, reduce transmission of HIV infection and reduce the global burden of chronic diseases, leading to a reduction of HIV global cost in the medium-long time.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3804-4) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

Quiros-Roldan

Magoni²,

Raffetti

et al. 2016

BMC Public Health

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“…[1][2][3][4][5][6] People living with HIV (PLWH) in the United States are now diagnosed with a number of age-related chronic conditions including cardiovascular disease, renal disease, and diabetes at rates at least as great as and often greater than those of HIV-uninfected populations. [7][8][9][10][11][12] A striking increase in obesity [body mass index (BMI) ‡30 kg/m is known regarding the associations of race, sex, and obesity with CMD risk.…”

Section: Introductionmentioning

confidence: 99%

Obesity Is Associated with Race/Sex Disparities in Diabetes and Hypertension Prevalence, But Not Cardiovascular Disease, Among HIV-Infected Adults

Willig

Westfall

Overton

et al. 2015

AIDS Research and Human Retroviruses

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Race/sex differences are observed in cardiometabolic disease (CMD) risk and prevalence in the context of treated, chronic HIV infection, and these differences could be exacerbated by disparities in obesity prevalence. We sought to determine the effect of obesity on these disparities among people living with HIV. Prevalence of CMD (dyslipidemia, cardiovascular disorders, hypertension, diabetes, chronic kidney disease) was determined for patients seen at the University of Alabama at Birmingham HIV clinic between 7/2010 and 6/2011. Staged logistic regression was used to examine the impact of race/sex on comorbidities adjusting for key confounders including/ excluding obesity (body mass index ‡30 kg/m 2 ). Of 1,800 participants, 77% were male, 54% were black, and 25% were obese. Obesity prevalence differed by race/sex: black women 49%, black men 24%, white women 24%, white men 15% ( p < 0.01). Compared to white men, other groups had reduced odds for dyslipidemia and cardiovascular disorders ( p < 0.01). Black men had increased odds for hypertension and chronic kidney disease, while black women had a nearly 2-fold increased odds for diabetes and hypertension (all at p < 0.01). The associations of black women with diabetes and hypertension were attenuated when obesity was included in the models. Other group differences remained significant. Disparities in obesity prevalence do not explain race/sex differences in all CMD among people with HIV. Obesity accounted for associations with diabetes/hypertension for black women, who may benefit from weight reduction to decrease disease risk. Further investigations into the etiology and treatment of CMD in people living with HIV should consider unique race/sex treatment issues.

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“…Comparatively, per-capita costs for other important chronic pathologies, such as HIV infection, severe psychiatric disorders, gastrointestinal diseases, neuropathies and neoplasms, were €9894, €8928, €7199, €6366 and €5470, respectively. Interestingly, the per-capita cost of HIV infection alone was €8104 versus €9895 in the case of association of HIV and diabetes [49].…”

Section: Figure 3 Distribution Of Overall Drug Costs For Individualsmentioning

confidence: 99%

The impact of diabetes mellitus on healthcare costs in Italy

Giorda¹,

Manicardi²,

Cabezudo³

2011

Expert Review of Pharmacoeconomics & Outcomes Research

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Diabetes mellitus is an increasingly common chronic disease that has a great impact not only in terms of clinical effects, but also in terms of economic burden worldwide. Expenditures due to diabetes derive essentially from direct and indirect costs. Current estimates of global healthcare expenditures due to diabetes are US$376 billion and are expected to increase to US$490 billion by 2030. In particular, costs associated with diabetes-related complications represent the most relevant part of the national healthcare expenditure for diabetes and are higher than the costs of managing diabetes itself. The major expenditure depends on the type and the number of complications: cardiovascular complications increase direct costs, especially for hospitalization. Moreover, diabetic comorbidity has a greater economic impact on the health expenditure in comparison with those patients without diabetes. In Europe, the CODE-2 study was the first attempt to evaluate the costs of diabetes: the annual costs per patient were estimated at €2384 and the highest value, €2991, was registered in Italy. This indicates an overall annual cost of €5170 million for the whole Italian population with diabetes. Current estimates for 2010 healthcare expenditure for diabetes are US$105 billion (10% of total healthcare expenditure, US$2046 per person) for the whole European region, and US$11 billion (9% of total healthcare expenditure, US$2087 per person) for Italy. More studies are needed in order to better define the real significance of the healthcare costs of diabetes in Italy. An effective therapy with a good metabolic control can reduce the risk of complications and represents a valid strategy from an economic point of view.

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The evolving burden of HIV infection compared with other chronic diseases in northern Italy*

Cited by 19 publications

References 10 publications

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

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

Obesity Is Associated with Race/Sex Disparities in Diabetes and Hypertension Prevalence, But Not Cardiovascular Disease, Among HIV-Infected Adults

The impact of diabetes mellitus on healthcare costs in Italy

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