Morales Daniel R, Moreno-Martos David, Matin Nashaba, McGettigan Patricia
Division of Population Health and Genomics, University of Dundee, Dundee, United Kingdom.
Department of Public Health, University of Southern Denmark, Denmark.
EClinicalMedicine. 2022 Apr 21;47:101392. doi: 10.1016/j.eclinm.2022.101392. eCollection 2022 May.
Life expectancy in adults with human immunodeficiency virus (HIV) has increased and managing other health conditions is increasingly important for patients and healthcare planning. The aim of this study was to examine the prevalence and association between different health conditions and HIV status.
We performed a cross-sectional analysis of adult UK Clinical Practice Research Datalink primary care electronic medical records linked to hospital admissions as of Nov 30, 2015. We examined 47 health condition groups and 304 physical and mental health conditions by HIV status, after adjustment for age, sex, social deprivation status using logistic regression.
There were 964 patients with HIV (61.7% male; 92.8% aged <65 years) and 941,113 non-HIV patients (49.4% male; 75.2% aged <65 years). Condition groups with the greatest prevalence in HIV that were also highly prevalent in adults without HIV included: lipid disorder (41.4% vs 40.2%), and hypertension (19.1% vs 24.6%). Following adjustment, 18 (37.5%) condition groups were more likely in adults with HIV and ten (20.8%) were less likely. Individual conditions that were less likely in adults with HIV included: atrial fibrillation (odds ratio [OR] 0.37 [95% CI 0.20-0.64]) and hypertension (OR_0.78 [0.65-0.94]); rheumatoid arthritis (OR 0.27 [0.05-0.84]); asthma (OR_0.65 (0.53-0.80]); and certain eye diseases such as macular degeneration (OR_0.30 [0.09-0.70]). Meanwhile individual conditions that were more likely included: liver fibrosis, sclerosis, and cirrhosis (OR_3.23 [1.85-5.20]); pulmonary embolism (OR_2.06 [1.15-3.36]); male infertility (OR_2.23 [1.50-3.16]) and female infertility (OR_2.01 [1.34-2.88]); bipolar disorder (OR_2.93 [1.52-5.05]) and depression (OR_1.49 [1.28-1.71]); cervical malignancy (OR_4.64 [1.15-12.15]); and infections.
Comorbidity is common in adults with HIV, with physical and mental health conditions spanning a wide spectrum. HIV management should consider multidisciplinary care models to provide optimal patient care.
The project was funded by the Bart's Charity; DRM was funded by a Wellcome Trust Clinical Research Career Development Fellowship; DRM and DMM received funding from the HDR-UK Precision therapeutics programme.
感染人类免疫缺陷病毒（HIV）的成年人预期寿命有所增加，对于患者和医疗保健规划而言，管理其他健康状况变得愈发重要。本研究旨在调查不同健康状况与HIV状态之间的患病率及关联。
我们对截至2015年11月30日与医院入院记录相关联的英国临床实践研究数据链初级保健电子病历进行了横断面分析。在对年龄、性别、社会剥夺状况进行逻辑回归调整后，我们按HIV状态检查了47个健康状况组以及304种身心健康状况。
有964例HIV患者（男性占61.7%；92.8%年龄小于65岁）和941,113例非HIV患者（男性占49.4%；75.2%年龄小于65岁）。在HIV患者中患病率最高且在未感染HIV的成年人中也普遍存在的状况组包括：脂质紊乱（41.4%对40.2%）和高血压（19.1%对24.6%）。调整后，18个（37.5%）状况组在HIV成年患者中更常见，10个（20.8%）则较少见。在HIV成年患者中较少见的个体状况包括：心房颤动（比值比[OR]0.37[95%置信区间0.20 - 0.64]）和高血压（OR_0.78[0.65 - 0.94]）；类风湿关节炎（OR 0.27[0.05 - 0.84]）；哮喘（OR_0.65(0.53 - 0.80]）；以及某些眼部疾病，如黄斑变性（OR_0.30[0.09 - 0.70]）。同时，更常见的个体状况包括：肝纤维化、硬化和肝硬化（OR_3.23[1.85 - 5.20]）；肺栓塞（OR_2.06[1.15 - 3.36]）；男性不育（OR_2.23[1.50 - 3.16]）和女性不育（OR_2.01[1.34 - 2.88]）；双相情感障碍（OR_2.93[1.52 - 5.05]）和抑郁症（OR_1.49[1.28 - 1.71]）；宫颈恶性肿瘤（OR_4.64[1.
