Abstract
BackgroundAmong 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.MethodsCross-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.ResultsOne 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.ConclusionsMore 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.
Highlights
Among people living with Human Immunodeficiency Virus (HIV) (PLWH), the prevalence of non-HIV related co-morbidities is increasing
In our sample of patients attending the HIV-outpatient facilities in the participating centers, we found that most PLHW were multi-morbid and about 30% had three or more concurrent conditions
Besides other known risk factors, shared with the general population, such as age, body mass index (BMI) and cigarette smoking, we found that Center for Diseases Control (CDC) stage, duration of antiretroviral therapy (ART) and current CD4 cell count < 200 cells/ mm3 were risk factors for multi-morbidity
Summary
Among people living with HIV (PLWH), the prevalence of non-HIV related co-morbidities is increasing. The prevalence of co-morbidities among Persons Living With HIV infection (PLWH) increased, as a consequence of aging, chronic inflammation, systemic immune activation, and long-term exposure to the combination antiretroviral therapy (ART) [1,2,3]. For this reason, PLWH had an increased use of non-antiretroviral drugs as compared to the general population [4]. Investigating common patterns and disease-disease interactions between co-morbidities could support the development of intervention models, improve the management of multi-morbid patients, and provide indication for prevention of multiple comorbidities in PLWH [12].
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