Southwest CARE Center, Santa Fe, New Mexico.
University of California San Francisco, San Francisco.
J Infect Dis. 2017 Dec 19;216(12):1525-1533. doi: 10.1093/infdis/jix518.
Quantify proportion of human immunodeficiency virus (HIV)-infected patients with specific comorbidities receiving healthcare coverage from commercial, Medicaid, and Medicare payers.
Data from MarketScan research databases were used to select adult HIV-infected patients from each payer. Treated HIV-infected patients were matched to HIV-negative controls. Cross-sectional analyses were performed between 2003 and 2013 among HIV-infected patients to quantify the proportion with individual comorbidities over the period, by payer.
Overall, 36298 HIV-infected patients covered by commercial payers, 26246 covered by Medicaid payers, and 1854 covered by Medicare payers were identified between 2003 and 2013. Essential hypertension (31.4%, 39.3%, and 76.2%, respectively), hyperlipidemia (29.2%, 22.1%, and 49.6%), and endocrine disease (21.8%, 27.2%, and 54.0%) were the most common comorbidities. Comparison of data from 2003 to data from 2013 revealed significant increases across payers in the percentage of patients with the comorbidities specified above (P < .05). Across all payers, the proportions of treated HIV-infected patients with deep vein thrombosis, hepatitis C, renal impairment, thyroid disease, and liver disease from 2003 to 2013 was significantly greater (P < .05) than for matched controls.
Comorbidities are common among the aging HIV-infected population and have increased over time. There should be a consideration in treatment choices for HIV infection, including the choices of antiretroviral regimens.
量化患有特定合并症的人类免疫缺陷病毒（HIV）感染患者从商业、医疗补助和医疗保险支付者获得医疗保健覆盖的比例。
使用 MarketScan 研究数据库中的数据从每个支付者中选择成年 HIV 感染患者。对接受治疗的 HIV 感染患者与 HIV 阴性对照进行匹配。在 2003 年至 2013 年期间对 HIV 感染患者进行横断面分析，以量化在此期间每个支付者中具有个体合并症的患者比例。
在 2003 年至 2013 年期间，共确定了 36298 名商业支付者覆盖的 HIV 感染患者、26246 名医疗补助支付者覆盖的 HIV 感染患者和 1854 名医疗保险支付者覆盖的 HIV 感染患者。高血压（31.4%、39.3%和 76.2%）、高脂血症（29.2%、22.1%和 49.6%）和内分泌疾病（21.8%、27.2%和 54.0%）是最常见的合并症。比较 2003 年和 2013 年的数据发现，上述合并症患者的比例在所有支付者中均显著增加（P <.05）。在所有支付者中，2003 年至 2013 年期间，患有深静脉血栓形成、丙型肝炎、肾功能不全、甲状腺疾病和肝脏疾病的接受治疗的 HIV 感染患者的比例显著大于匹配对照（P <.05）。
合并症在老龄化的 HIV 感染人群中很常见，并且随着时间的推移而增加。在治疗 HIV 感染时，包括选择抗逆转录病毒方案时，应考虑合并症。
