Aging with HIV: Comorbidities Increase Faster Than in Others

JANUARY 03, 2018
Jeannette Y. Wick, RPh, MBA, FASCP
What has changed in HIV over time?

This is a question of great interest to researchers right now since the average lifespan among individuals with HIV in developed nations continues to improve. A study completed in 2013 found that although a gap in life expectancy exists between individuals with HIV and those who are not infected, the gap has narrowed. The lifespan of those with HIV is approximately 8 to 13 years shorter than others’. But again, the gap is narrowing.

Researchers from across the United States collaborated to conduct a study looking at comorbidities among Americans. Their goal was to analyze trends and determine which comorbidities are most common today. Published in the Journal of Infectious Diseases in its December 2017 issue, the results indicated that comorbidities have increased among individuals with HIV over time. The researchers reported that this trend must influence choice of antiviral regimen.

This study looked at more than 66,000 patients with HIV who were covered by private insurers, Medicare, or Medicaid between 2003 and 2013.

The most common comorbidity was hypertension followed by hyperlipidemia and endocrine disease. Prevalence of both increased significantly from 2003 to 2013.
In addition, regardless of the insurer, patients with HIV were more likely to have deep vein thrombosis, hepatitis C, renal impairment, thyroid disease, or hepatic dysfunction than matched controls.

With renal impairment and cardiovascular events, the magnitude of the difference between individuals with HIV and others was pronounced, especially in the Medicare population. In addition, patients with HIV are significantly more likely to have diabetes.

The researchers noted that the HIV population tends to be older than ever before. They remind healthc are practitioners that they should be vigilant for cardiovascular complications, kidney disease, osteoporosis, and bone fracture. They also indicated that for many individuals with HIV, comorbidities limit the choice of antiretroviral therapy.

Gallant J, Hsue PY, Shreay S, Meyer N. Comorbidities among US Patients with prevalent hiv infection-A trend analysis. J Infect Dis. 2017;216(12):1525-1533.

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