University of Wisconsin-Madison, School of Social Work, Madison, Wisconsin, USA.
Columbia University, Mailman School of Public Health, New York, New York, USA.
Clin Infect Dis. 2021 Oct 5;73(7):e1957-e1963. doi: 10.1093/cid/ciaa1760.
Due to the advent and success of antiretroviral therapy, the number of people living and aging with human immunodeficiency virus (HIV) has grown substantially. Although people living with HIV (PLHIV) are experiencing longer life expectancies, this achievement may be undermined by increasing and disproportionate chronic disease burden among PLHIV.
This study is a retrospective analysis of adult (≥18 years) inpatient hospital discharges from a large hospital system in the New York City, New York metropolitan area, between 1 January 2006 and 31 December 2016. We aimed to investigate (1) changes in the prevalence of Charlson-defined comorbidities among PLHIV hospitalized between 2006 and 2016 and (2) changes in the unadjusted prevalence ratio (PR) of comorbidities in HIV-positive versus HIV-negative admissions over time.
Of 898 139 hospital admissions from 2006-2016, 19 039 (2.1%) were HIV positive. Across all admissions during the study period, the greatest comorbidity disparities between HIV-positive and HIV-negative admissions were mild liver disease (PR, 4.9 [95% confidence interval, 4.8-5.1]), moderate or severe liver disease (PR, 2.2 [2.0-2.4]), and chronic pulmonary disease (PR, 1.8 [1.8-1.8]).
The prevalence and relative burden of comorbidities among hospitalized PLHIV are changing over time. Careful monitoring and intensive discharge planning may be effective strategies for addressing the evolving health needs of PLHIV.
由于抗逆转录病毒疗法的出现和成功，感染人类免疫缺陷病毒 (HIV) 的人数大幅增加，并且这些人得以存活和衰老。尽管 HIV 感染者 (PLHIV) 的预期寿命有所延长，但这一成就可能因 PLHIV 中不断增加和不成比例的慢性疾病负担而受到影响。
本研究是对纽约市纽约大都市区一家大型医院系统 2006 年 1 月 1 日至 2016 年 12 月 31 日期间成年（≥18 岁）住院患者的回顾性分析。我们旨在调查：（1）2006 年至 2016 年间住院的 PLHIV 中 Charlson 定义的合并症的患病率变化；（2）HIV 阳性与 HIV 阴性入院患者合并症的未调整患病率比值 (PR) 随时间的变化。
在 2006-2016 年期间的 898139 例住院患者中，有 19039 例（2.1%）HIV 阳性。在整个研究期间的所有入院患者中，HIV 阳性与 HIV 阴性入院患者之间最大的合并症差异是轻度肝脏疾病（PR，4.9 [95%置信区间，4.8-5.1]）、中度或重度肝脏疾病（PR，2.2 [2.0-2.4]）和慢性肺部疾病（PR，1.8 [1.8-1.8]）。
住院 PLHIV 中合并症的患病率和相对负担随时间而变化。仔细监测和强化出院计划可能是解决 PLHIV 不断变化的健康需求的有效策略。
