In the Journals Plus

Multimorbidity increasing among patients with HIV

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December 7, 2017

The prevalence of multimorbidity rose from 8.2% to 22.4% in the United States between 2000 and 2009 among people living with HIV who received treatment, according to data published in Clinical Infectious Diseases.

“In the context of HIV infection, multimorbidity may have far-reaching implications given the increases in numbers of [persons living with HIV (PLWH)] aged 50 years or older, the clinical complexity of care for older PLWH, as well as its impact on psychosocial and physical well-being of affected individuals,” Cherise Wong, PhD, from the department of epidemiology at Johns Hopkins Bloomberg School of Public Health, and colleagues wrote. “To date, no study has described temporal trends in multimorbidity prevalence within a large U.S. population of PLWH.”

Researchers assessed trends in the co-occurrence of age-associated conditions among a cohort of PLWH receiving ART and clinical care enrolled in the North American AIDS Cohort Collaboration on Research and Design in the U.S. from 2000 to 2009. They also examined differences in their prevalence by demographic subgroup. Multimorbidity, defined as having two or more conditions, included hypertension, diabetes, chronic kidney disease, hypercholesterolemia, end-stage liver disease or non-AIDS-related cancer.

In total, 22,969 adult PLWH were included in the study. Analysis showed that multimorbidity prevalence increased from 8.2% in 2000 to 22.4% in 2009 (P trend < .001) in the U.S. This trend remained significant after adjusting for age (P < .001). Although there was no difference by sex, whites were more likely to have multimorbidity than blacks (adjusted prevalence ratio [PR] = 0.87; 95% CI, 0.77-0.99). Heterosexuals had the highest prevalence of multimorbidity compared with men who have sex with men (aPR = 1.16; 95% CI, 1.01-1.34). The most frequently occurring conditions were hypertension and hypercholesterolemia, the researchers said.

“Multimorbidity is increasing in a representative population of PLWH receiving U.S. clinical care,” Wong and colleagues wrote. “Although future research will benefit from disentangling underlying contributors to these observations, continued monitoring of multimorbidity epidemiology through a broader lens will be needed in order to minimize disparities, address the challenges of polypharmacy and inform health care system demand.” – by Savannah Demko

Disclosures: Wong reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.

itj+ Infographic

Infographic depicting multimorbidity prevalence in the U.S.