New research suggests an increasing proportion of patients with HIV are experiencing cardiovascular conditions, renal impairment and other life-threatening comorbidities.
“Advances in ART have obviously increased life expectancy for people with HIV, and as a result we’re seeing a lot more aging and … prolonged exposure to some agents (that) may also increase risk of cardiovascular, metabolic and renal comorbidities,” Dr Joel E Gallant, associate medical director of specialty services at Southwest CARE Center in Santa Fe, New Mexico, is quoted in a Healio report as saying. “HIV patients can have comorbidities that become risk factors for future diseases, such as cardiovascular or kidney disease. In addition, the choice of ART may also increase or accelerate the development of some of these events.”
Using data collected from Medicare, Medicaid and Truven Health MarketScan Commercial databases, Gallant and colleagues observed comorbidity rates among HIV patients from 2003 to 2013. Patients were only eligible for analysis if they were continuously enrolled for 1 or more years during the study period. The researchers collected demographic data, including age, gender and geographic region. Incidence of comorbidity was compared for 2003 and 2013, and over a period of time for patients continuously enrolled during 2009.
HIV patients identified in 2003 (n = 18,944) were 62.4% male (median age, 42 years), while those enrolled in 2013 (n = 20,355) were 69.3% male (median age, 48 years). Overall, there were higher rates of comorbidities or health events among HIV patients enrolled in 2013. Increases occurred in hypertension (32.2% vs. 15.7%), hyperlipidemia (24.3% vs. 7.7%), cardiovascular disease (4.3% vs. 2.9%), diabetes (12.7% vs. 8.3%) and renal impairment (7% vs. 4.4%). Similar trends also were frequent for all age groups in the yearly analysis starting in 2009. Gallant said this suggested that age may not be the sole influence on comorbidity incidence.
“Comorbidities will clearly affect the natural history of HIV infection in this aging population, and in some cases may affect our choice of therapy,W he said.