950. A Longitudinal Analysis of Comorbidities among Human Immunodeficiency Virus (HIV) Patients and Matched non-HIV Controls in the USA
Session: Oral Abstract Session: HIV Clinical Management
Friday, October 28, 2016: 11:00 AM
Room: 275-277

Background: Effective, well-tolerated antiretroviral (ARV) therapies have transformed the treatment of HIV. Patients are living longer, and increasingly present with or develop multiple comorbidities including risk factors for cardiovascular disease (CVD), renal disease (RD) and fracture/osteoporosis (FX). This study compared rates of comorbid conditions in HIV patients and non-HIV (HIV-) controls in 2003-2013.

Methods: Adults diagnosed with HIV (ICD-9 code: 042.xx, 795.71, V08) and had ARV therapy in 2003-2013 were selected from MarketScan Databases. HIV patients were matched to HIV- controls by payer and demographic variables. Patients had data for ≥ 365 days in 2003-2013.

Results: 21,180 Commercial HIV patients (mean age: 47.7; male: 84.4%) and 16,431 Medicaid HIV patients (mean age: 50.5; male: 53.4%) were extracted. Compared to HIV- patients, HIV patients had higher rates of CVD (Commercial 6.7% vs 3.8%; Medicaid 10.5% vs 7.7%), RD (8.7% vs 2.7%; 15.2% vs 6.0%) and FX (7.6% vs 6.1%; 13.0% vs 10.1%) (all p<0.001) (Table). Common comorbidities in HIV patients were hypertension (Commercial: 31.1%; Medicaid: 29.6%), hyperlipidemia (31.0%, 29.6%), and endocrine disease (including diabetes) (20.8%, 17.9%). Rates of CVD, RD and FX were higher in 2013 than in 2003, and rose from 2003-2013 (Figures) in HIV and HIV- patients in both commercial and Medicaid.

Conclusion: HIV patients have multiple comorbidities including risk factors for CVD, RD and FX. Rates of the risk factors and CVD, RD, and FX rose over time for both HIV patients and their controls. RD was higher in each year for HIV+ than HIV- in both commercial and Medicaid, and CVD was also higher in each year for HIV+ than HIV- in Commercial.

Table 1

 

Commercial (2003-2013)

Medicaid (2003-2013)

 

Cases

Controls

Cases

Controls

 

N=21,180

N=66,027

N=16,431

N=45,556

Age (mean, SD)

47.7 (10.5)

47.5 (10.3)

50.5 (10.0)

49.9 (10.1)

Ages 50+

12.9%

12.1%

18.2%

17.0%

Male (%)

84.4%

83.9%

53.4%

53.8%

 

 

 

 

 

Clinical conditions (%)

 

 

CVD

6.7%

3.8%

10.5%

7.7%

RD

8.7%

2.7%

15.2%

6.0%

FX

7.6%

6.1%

13.0%

10.1%

Diabetes

10.1%

10.0%

16.1%

18.2%

Hypertension

31.1%

29.6%

37.4%

34.0%

Hepatitis C

5.4%

0.5%

22.8%

3.8%

Hyperlipidemia

31.0%

29.6%

22.4%

24.1%

Obesity

5.6%

6.6%

7.7%

10.2%

Endocrine Disease

20.8%

17.9%

26.3%

24.7%

Figure 1

Figure 2

 

Priscilla Hsue, MD, Medicine, UCSF School of Medicine, San Francisco, CA, Sanatan Shreay, PhD, Medical Affairs, Gilead Sciences, Foster City, CA, Xue Song, PhD, Outcomes Research, Truven Health, Boston, MA and Nicole Meyer, PhD, Health Outcomes Research, Truven Health, Cambridge, MA

Disclosures:

P. Hsue, Gilead Sciences: Investigator , Consulting fee and Research support

S. Shreay, Gilead Sciences: Employee , Salary

X. Song, Gilead Sciences: Consultant , Consulting fee

N. Meyer, Gilead Sciences: Consultant , Consulting fee

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