The Lister Hill National Center for Biomedical Communications at the National Library of Medicine, National Institutes of Health in the United States, Bethesda, Maryland.
Division of Infectious Diseases and International Medicine at the University of Minnesota School of Medicine, Minnesota.
Medicine (Baltimore). 2021 Apr 23;100(16):e25428. doi: 10.1097/MD.0000000000025428.
The objective of this paper is to determine the temporal trend of the association of 66 comorbidities with human immunodeficiency virus (HIV) infection status among Medicare beneficiaries from 2000 through 2016.We harvested patient level encounter claims from a 17-year long 100% sample of Medicare records. We used the chronic conditions warehouse comorbidity flags to determine HIV infection status and presence of comorbidities. We prepared 1 data set per year for analysis. Our 17 study data sets are retrospective annualized patient level case histories where the comorbidity status reflects if the patient has ever met the comorbidity case definition from the start of the study to the analysis year.We implemented one logistic binary regression model per study year to discover the maximum likelihood estimate (MLE) of a comorbidity belonging to our binary classes of HIV+ or HIV- study populations. We report MLE and odds ratios by comorbidity and year.Of the 66 assessed comorbidities, 35 remained associated with HIV- across all model years, 19 remained associated with HIV+ across all model years. Three comorbidities changed association from HIV+ to HIV- and 9 comorbidities changed association from HIV- to HIV+.The prevalence of comorbidities associated with HIV infection changed over time due to clinical, social, and epidemiological reasons. Comorbidity surveillance can provide important insights into the understanding and management of HIV infection and its consequences.
本文旨在确定从 2000 年到 2016 年，医疗保险受益人群中 66 种合并症与人类免疫缺陷病毒（HIV）感染状况之间的关联的时间趋势。我们从长达 17 年的 Medicare 记录 100%样本中收集了患者水平的就诊记录。我们使用慢性疾病仓库合并症标志来确定 HIV 感染状况和合并症的存在。我们每年准备一组数据进行分析。我们的 17 个研究数据集是回顾性的年度化患者水平病例史，其中合并症状态反映了患者从研究开始到分析年份是否符合合并症病例定义。我们每年为每个研究实施一个逻辑二元回归模型，以发现属于我们的 HIV+或 HIV-研究人群的二进制类别的合并症的最大似然估计（MLE）。我们按合并症和年份报告 MLE 和优势比。在评估的 66 种合并症中，有 35 种在所有模型年份中与 HIV-相关，有 19 种在所有模型年份中与 HIV+相关。有 3 种合并症的关联从 HIV+变为 HIV-，有 9 种合并症的关联从 HIV-变为 HIV+。由于临床、社会和流行病学原因，与 HIV 感染相关的合并症的患病率随时间发生了变化。合并症监测可以为理解和管理 HIV 感染及其后果提供重要的见解。
