2256. Racial Differences in dyslipidemia clinical characteristics and treatment among urban HIV patients
Session: Poster Abstract Session: HIV: Metabolic, Cardiovascular, and Renal Complications
Saturday, October 6, 2018
Room: S Poster Hall
Posters
  • PosterDyslipidemia_IDWeek_26sep2018_ZO.pdf (203.7 kB)
  • Background: Racial and ethnic minorities comprise an increasing proportion of the US population, and are disproportionately affected by HIV. Dyslipidemia is a key comorbidity in HIV due to high prevalence and demonstrated racial disparities in testing and treatment among non-HIV patients. Previous analysis has showed that HIV positive African American (AA) patients were less likely to have had a lipid profile done and less likely to have been diagnosed with dyslipidemia than other racial groups.

    Methods: Electronic medical records (EMR) identified 1457 HIV patients from the HIV clinic at Henry Ford Hospital, Detroit, Michigan from March, 2013 to November, 2015. Race/ethnicity and gender were identified by self-report and then a retrospective EMR review of patients tested for, and documented ICD-9 codes for dyslipidemia was done. Descriptive analyses and group comparisons were performed between AA and other racial/ethnic groups.

    Results: 1220 HIV patients had lipid levels tested with 25.7% having dyslipidemia after HIV diagnosis. Among those, it was found that lipid abnormalities varied by race; on average, Hispanics, had lower total cholesterol (p-value 0.040), AA patients had lower triglycerides (p-value <0.001), and White patients had higher triglycerides (p-value >0.001). HDL levels were higher in AA patients and lowest in White patients (p-value <0.001), while Hispanics had lower LDL values (p-value 0.009). There was no statistically significant (p-value 0.519) difference between the lipid lowering drug (LLD) group prescribed by race, and the type of dyslipidemia was the primary predictor of LLD provided to the patients (p-values <0.001). Patients prescribed fibrates were statistically more likely to have met their ATP III treatment goals at 1 year as compared to statins, regardless of race (p-value 0.005). The odds of meeting treatment goals were 54% (OR 0.46, CI 0.26-0.71) less among AA patients regardless of medication.

    Conclusion: Dyslipidemia is prevalent in our HIV population. Racial differences in testing, lipid abnormalities and treatment outcomes among these vulnerable HIV minorities necessitate further investigation to close the gaps in care and improve our management of dyslipidemia for our HIV patients.

    Zachary Osborn, MPH, Medicine- Infectious Diseases, Henry Ford Hospital, Detroit, MI, Christine Joseph, Ph.D., Henry Ford Health System, Detroit, MI and John Mckinnon, MD, MSc, Medicine / Infectious Diseases, Henry Ford Hospital, Detroit, MI

    Disclosures:

    Z. Osborn, None

    C. Joseph, None

    J. Mckinnon, None

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