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The prevalence and risk of non-infectious comorbidities in HIV-infected and non-HIV infected men attending general practice in Australia


Autoři: Jack Edward Heron aff001;  Sarah M. Norman aff002;  Jeannie Yoo aff002;  Kirsty Lembke aff002;  Catherine C. O’Connor aff003;  Clare E. Weston aff002;  David M. Gracey aff001
Působiště autorů: Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia aff001;  NPS MedicineWise, Sydney, New South Wales, Australia aff002;  Kirby Institute, University of NSW, Sydney, New South Wales, Australia aff003;  Central Clinical School, University of Sydney, Sydney, New South Wales, Australia aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0223224

Souhrn

Background

Non-AIDS-related mortality rates among HIV-infected patients still exceed those of their uninfected peers. A major driver of this excess mortality is a higher risk of non-infectious comorbidities, including cardiovascular disease, chronic kidney disease, type 2 diabetes mellitus, osteoporosis and cancer. The prevalence of mental illness and other chronic non-infectious comorbidities is identified as a primary concern of antiretroviral prescribers in Australia.

Methods

We conducted a cross-sectional, observational study using data from MedicineInsight, a large-scale Australian primary care database comprising longitudinal data from electronic clinical information systems. The HIV-infected cohort included all men with a recorded diagnosis of HIV. The non-HIV-infected cohort comprised all other men from the same practices. The prevalence and risk of cardiovascular disease, chronic kidney disease, type 2 diabetes mellitus, osteoporosis, cancer, anxiety and depression were compared between the groups.

Results

We included 2,406 HIV-infected males and 648,205 males with no record of HIV diagnosis attending primary care in this study. HIV-infected men were less socioeconomically disadvantaged and more urban-dwelling than men in the primary care cohort. We found that HIV-infected men attending primary care in Australia are at increased risk of chronic kidney disease, cancer, osteoporosis, anxiety and depression. There appears to be a risk of premature onset of cardiovascular disease, osteoporosis and cancer among younger HIV-infected patients. There is a high prevalence of anxiety and depression among HIV-infected men.

Conclusions

Increased prevalence of non-infectious comorbidities among HIV-infected men has broad implications for the effective management of those with these chronic conditions. Education to raise awareness among both HIV-infected men and their care providers, together with a greater focus on risk reduction, monitoring and preventive care, may be effective strategies in primary healthcare settings to further narrow the gap in health outcomes between people living with HIV and their uninfected counterparts.

Klíčová slova:

HIV diagnosis and management – Australia – Age groups – Chronic kidney disease – Cardiovascular diseases – Primary care – HIV epidemiology – Osteoporosis


Zdroje

1. Petoumenos K, Law MG, on behalf of the Australian HIV Observational Database. Risk factors and causes of death in the Australian HIV Observational Database. Sex Health. 2006;3(2):103–12. doi: 10.1071/SH05045 16800396

2. Kirby Institute. HIV in Australia: annual surveillance report 2018. Sydney, Australia: Kirby Institute, University of New South Wales, 2018.

3. de Coninck Z, Hussain-Alkhateeb L, Bratt G, Ekström AM, Gisslén M, Petzold M, et al. Non-AIDS mortality is higher among successfully treated people living with HIV compared with matched HIV-negative control persons: a 15-year follow-up cohort study in Sweden. AIDS Patient Care STDs. 2018;32(8):297–305. doi: 10.1089/apc.2018.0015 30067408

4. Shah ASV, Stelzle D, Lee KK, Beck EJ, Alam S, Clifford S, et al. Global burden of atherosclerotic cardiovascular disease in people living with HIV. Circulation. 2018;138(11):1100–12. doi: 10.1161/CIRCULATIONAHA.117.033369 29967196

5. Cheung J, Puhr R, Petoumenos K, Cooper DA, Woolley I, Gunathilake M, et al. Chronic kidney disease in Australian HIV‐infected patients: analysis of the Australian HIV Observational Database. Nephrology (Carlton). 2017. doi: 10.1111/nep.13100 28703924

6. Petoumenos K, Huang R, Hoy J, Bloch M, Templeton DJ, Baker D, et al. Prevalence of self-reported comorbidities in HIV positive and HIV negative men who have sex with men over 55 years—The Australian Positive & Peers Longevity Evaluation Study (APPLES). PloS One. 2017;12(9):e0184583. doi: 10.1371/journal.pone.0184583 28886173

7. Grund B, Peng G, Gibert CL, Hoy JF, Isaksson RL, Shlay JC, et al. Continuous antiretroviral therapy decreases bone mineral density. AIDS. 2009;23(12):1519. doi: 10.1097/QAD.0b013e32832c1792 19531929

8. Powles T, Robinson D, Stebbing J, Shamash J, Nelson M, Gazzard B, et al. Highly active antiretroviral therapy and the incidence of non–AIDS-defining cancers in people with HIV infection. J Clin Oncol. 2008;27(6):884–90. doi: 10.1200/JCO.2008.19.6626 19114688

9. McManus H, Petoumenos K, Franic T, Kelly MD, Watson J, O’Connor CC, et al. Determinants of suicide and accidental or violent death in the Australian HIV Observational Database. PloS One. 2014;9(2):e89089. doi: 10.1371/journal.pone.0089089 24586519

10. Mao L, Kippax SC, Newman CE, Andrews G, Rogers G, Saltman DC, et al. Rates of depression among men attending high-HIV-caseload general practices in Australia. Ment Health Fam Med. 2008;5(2):79. 22477852

11. Saltman DC, Newman CE, Mao L, Kippax SC, Kidd MR. Experiences in managing problematic crystal methamphetamine use and associated depression in gay men and HIV positive men: in-depth interviews with general practitioners in Sydney, Australia. BMC Fam Pract. 2008;9(1):45. doi: 10.1186/1471-2296-9-45 18702829

12. Smith D, Woolley I, Russell D, Bisshop F, Furner V. HIV in practice: current approaches and challenges in the diagnosis, treatment and management of HIV infection in Australia. HIV Med. 2018;19:5–23. doi: 10.1111/hiv.12637 29927516

13. Althoff KN, McGinnis KA, Wyatt CM, Freiberg MS, Gilbert C, Oursler KK, et al. Comparison of risk and age at diagnosis of myocardial infarction, end-stage renal disease, and non-AIDS-defining cancer in HIV-infected versus uninfected adults. Clin Infect Dis. 2014;60(4):627–38. doi: 10.1093/cid/ciu869 25362204

14. Guaraldi G, Orlando G, Zona S, Menozzi M, Carli F, Garlassi E, et al. Premature age-related comorbidities among HIV-infected persons compared with the general population. Clin Infect Dis. 2011;53(11):1120–6. doi: 10.1093/cid/cir627 21998278

15. Glass T, Ungsedhapand C, Wolbers M, Weber R, Vernazza P, Rickenbach M, et al. Prevalence of risk factors for cardiovascular disease in HIV-infected patients over time: the Swiss HIV Cohort Study. HIV Med. 2006;7(6):404–10. doi: 10.1111/j.1468-1293.2006.00400.x 16903986

16. NPS MedicineWise. General Practice Insights Report July 2016–June 2017: A working paper. Sydney, Australia: NPS MedicineWise, 2018.

17. Australian Bureau of Statistics. Australian statistical geography standard (ASGS): Volume 5—Remoteness structure, July 2016. Canberra: ABS; 2018 [cited 7 May 2018]. Available from: http://www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/1270.0.55.005Main%20Features1July%202016.

18. Australian Bureau of Statistics. Socio-economic indexes for areas. Canberra: ABS; 2018 [cited 7 May 2018]. Available from: http://www.abs.gov.au/websitedbs/censushome.nsf/home/seifa.

19. Australian Digital Health Agency. SNOMED CT AU and Australian Medicines Terminology (AMT) Canberra: ADHA; 2017 [cited 24 May 2018]. Available from: https://www.digitalhealth.gov.au/news-and-events/news/snomed-ct-au-and-australian-medicines-terminology-amt-august-2017-release.

20. Komiti A, Judd F, Grech P, Mijch A, Hoy J, Williams B, et al. Depression in people living with HIV/AIDS attending primary care and outpatient clinics. Aust N Z J Psychiatry. 2003;37(1):70–7. doi: 10.1046/j.1440-1614.2003.01118.x 12534660

21. Sewell MC, Goggin KJ, Rabkin JG, Ferrando SJ, McElhiney MC, Evans S. Anxiety syndromes and symptoms among men with AIDS: a longitudinal controlled study. Psychosomatics. 2000;41(4):294–300. doi: 10.1176/appi.psy.41.4.294 10906351

22. Pence BW, Miller WC, Gaynes BN, Eron JJ Jr. Psychiatric illness and virologic response in patients initiating highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2007;44(2):159–66. doi: 10.1097/QAI.0b013e31802c2f51 17146374

23. Franceschi S, Lise M, Clifford G, Rickenbach M, Levi F, Maspoli M, et al. Changing patterns of cancer incidence in the early-and late-HAART periods: the Swiss HIV Cohort Study. Br J Cancer. 2010;103(3):416. doi: 10.1038/sj.bjc.6605756 20588274

24. Helleberg M, Gerstoft J, Afzal S, Kronborg G, Larsen CS, Bojesen SE, et al. Risk of cancer among HIV-infected individuals compared to the background population: impact of smoking and HIV. AIDS. 2014;28(10):1499–508. doi: 10.1097/QAD.0000000000000283 24785952

25. Currier JS, Taylor A, Boyd F, Dezii CM, Kawabata H, Burtcel B, et al. Coronary heart disease in HIV-infected individuals. J Acquir Immune Defic Syndr. 2003;33(4):506–12. doi: 10.1097/00126334-200308010-00012 12869840

26. Triant VA, Lee H, Hadigan C, Grinspoon SK. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92(7):2506–12. doi: 10.1210/jc.2006-2190 17456578

27. Compston J. HIV infection and osteoporosis. Bonekey Rep. 2015;4:636. doi: 10.1038/bonekey.2015.3 25709813

28. Schouten J, Wit FW, Stolte IG, Kootstra NA, van der Valk M, Geerlings SE, et al. Cross-sectional comparison of the prevalence of age-associated comorbidities and their risk factors between HIV-infected and uninfected individuals: the AGEhIV cohort study. Clin Infect Dis. 2014;59(12):1787–97. doi: 10.1093/cid/ciu701 25182245

29. Australian Institute of Health and Welfare. Chronic kidney disease compendium. Canberra, Australia: Australian Government; 2017 [cited 27 December 2018]. Available from: https://www.aihw.gov.au/reports/chronic-kidney-disease/chronic-kidney-disease-compendium/contents/how-many-australians-have-chronic-kidney-disease.

30. Estrella MM, Parekh RS, Astor BC, Bolan R, Evans RW, Palella FJ Jr, et al. Chronic kidney disease and estimates of kidney function in HIV infection: a cross-sectional study in the multicenter AIDS cohort study. J Acquir Immune Defic Syndr. 2011;57(5):380. doi: 10.1097/QAI.0b013e318222f461 21646913

31. Mocroft A, Kirk O, Reiss P, De Wit S, Sedlacek D, Beniowski M, et al. Estimated glomerular filtration rate, chronic kidney disease and antiretroviral drug use in HIV-positive patients. AIDS. 2010;24(11):1667–78. doi: 10.1097/QAD.0b013e328339fe53 20523203

32. Szczech LA, Grunfeld C, Scherzer R, Canchola JA, Van Der Horst C, Sidney S, et al. Microalbuminuria in HIV infection. AIDS. 2007;21(8):1003. doi: 10.1097/QAD.0b013e3280d3587f 17457094

33. Choi AI, Li Y, Deeks SG, Grunfeld C, Volberding PA, Shlipak MG. Association between kidney function and albuminuria with cardiovascular events in HIV-infected persons. Circulation. 2010;121(5):651–8. doi: 10.1161/CIRCULATIONAHA.109.898585 20100969


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