biostudies-literatureWong COntario Ministry of Health and Long Term CareNICHD NIH HHSNCATS NIH HHSNIDA NIH HHSNCRR NIH HHSNIA NIH HHSNIAID NIH HHSNIAAA NIH HHSHealth Resources and Services AdministrationCanadian Institutes of Health ResearchCIHRNEI NIH HHSAgency for Healthcare Research and QualityNIMHD NIH HHSNational Cancer InstituteNCI NIH HHS1230-1238https://www.ebi.ac.uk/biostudies/studies/S-EPMC5889007biostudies-literatureUnknown66(8)<h4>Background</h4>Age-associated conditions are increasingly common among persons living with human immunodeficiency virus (HIV) (PLWH). A longitudinal investigation of their accrual is needed given their implications on clinical care complexity. We examined trends in the co-occurrence of age-associated conditions among PLWH receiving clinical care, and differences in their prevalence by demographic subgroup.<h4>Methods</h4>This cohort study was nested within the North American AIDS Cohort Collaboration on Research and Design. Participants from HIV outpatient clinics were antiretroviral therapy-exposed PLWH receiving clinical care (ie, ≥1 CD4 count) in the United States during 2000-2009. Multimorbidity was irreversible, defined as having ≥2: hypertension, diabetes mellitus, chronic kidney disease, hypercholesterolemia, end-stage liver disease, or non-AIDS-related cancer. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) comparing demographic subgroups were obtained by Poisson regression with robust error variance, using generalized estimating equations for repeated measures.<h4>Results</h4>Among 22969 adults, 79% were male, 36% were black, and the median baseline age was 40 years (interquartile range, 34-46 years). Between 2000 and 2009, multimorbidity prevalence increased from 8.2% to 22.4% (Ptrend < .001). Adjusting for age, this trend was still significant (P < .001). There was no difference by sex, but blacks were less likely than whites to have multimorbidity (aPR, 0.87; 95% CI, .77-.99). Multimorbidity was the highest among heterosexuals, relative to men who have sex with men (aPR, 1.16; 95% CI, 1.01-1.34). Hypertension and hypercholesterolemia most commonly co-occurred.<h4>Conclusions</h4>Multimorbidity prevalence has increased among PLWH. Comorbidity prevention and multisubspecialty management of increasingly complex healthcare needs will be vital to ensuring that they receive needed care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of AmericaMultimorbidity Among Persons Living with Human Immunodeficiency Virus in the United States.PMC5889007K01 AI131895K24 DA000432U01 AI038858U01 AI038855KL2 TR000421R01 DA011602U01 AI068636R01 AA016893U01 AA020790U01 AI103401U01 AI103408UL1 TR000083U01 AI068634K23 EY013707U10 EY008067P30 AI027767TGF-96118CBR-94036P30 AI027763U01 AI031834U01 AI034989HCP-97105U01 AI037613U01 AI103397P30 AI036219U01 HD032632UM1 AI035043UL1 TR000004U01 AI035039U24 AA020794U01 AI103390U01 AI042590M01 RR000052R01 CA165937P30 AI050410K01 AI093197U10 EY008057P30 AI027757U01 AA013566P30 AI110527UL1 TR000454U01 AI034994F31 DA037788U01 AI034993U01 AI035004U10 EY008052U01 AI037984U01 AI035041U01 AI035040G12 MD007583U01 AI035042R24 AG044325UL1 RR024131P30 AI094189R24 AI067039U01 DA036935K24 AI065298R01 AG05310090051652CBR-86906R01 DA01256890047713U01 AI069918U54 MD007587Z01 CP010176U01 AI069432K24 AI118591U01 AI069434Gebo KAKlein MBRabkin CSSaag MSHunter-Mellado RFSterling TRMugavero MJGloberman JHaas DPatel PEron JJAnastos KGange SJKitahata MMHarrigan PRMoore RDBoswell SBenson CAKoethe JRJustice ACMayor ACrane HMNorth American AIDS Cohort Collaboration on Research and Design (NA-ACCORD)Bosch RJPalella FJMartin JNRachlis ARAlthoff KNAbraham AGCescon ARourke SBSamji HFiellin DBuchacz KMayer KHHogg RSMontaner JSDrozd DRKopansky-Giles MBoyd CMRodriguez BGabler KWong CGill MJMcKaig RGThorne JTurner MWillig JBebawy SSilverberg MJRogers BDubrow RJacobson LPNapravnik SKirk GDRebeiro PFBrooks JTGrasso CHorberg MAFreeman AMfalseMultimorbidity Among Persons Living with Human Immunodeficiency Virus in the United States.<h4>Background</h4>Age-associated conditions are increasingly common among persons living with human immunodeficiency virus (HIV) (PLWH). A longitudinal investigation of their accrual is needed given their implications on clinical care complexity. We examined trends in the co-occurrence of age-associated conditions among PLWH receiving clinical care, and differences in their prevalence by demographic subgroup.<h4>Methods</h4>This cohort study was nested within the North American AIDS Cohort Collaboration on Research and Design. Participants from HIV outpatient clinics were antiretroviral therapy-exposed PLWH receiving clinical care (ie, ≥1 CD4 count) in the United States during 2000-2009. Multimorbidity was irreversible, defined as having ≥2: hypertension, diabetes mellitus, chronic kidney disease, hypercholesterolemia, end-stage liver disease, or non-AIDS-related cancer. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) comparing demographic subgroups were obtained by Poisson regression with robust error variance, using generalized estimating equations for repeated measures.<h4>Results</h4>Among 22969 adults, 79% were male, 36% were black, and the median baseline age was 40 years (interquartile range, 34-46 years). Between 2000 and 2009, multimorbidity prevalence increased from 8.2% to 22.4% (Ptrend < .001). Adjusting for age, this trend was still significant (P < .001). There was no difference by sex, but blacks were less likely than whites to have multimorbidity (aPR, 0.87; 95% CI, .77-.99). Multimorbidity was the highest among heterosexuals, relative to men who have sex with men (aPR, 1.16; 95% CI, 1.01-1.34). Hypertension and hypercholesterolemia most commonly co-occurred.<h4>Conclusions</h4>Multimorbidity prevalence has increased among PLWH. Comorbidity prevention and multisubspecialty management of increasingly complex healthcare needs will be vital to ensuring that they receive needed care.2018-01-01T00:00:00Z2018 Apr2025-04-26T18:15:13.558Z2019-08-04T07:30:23ZS-EPMC58890072914923710.1093/cid/cix998