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艾滋病毒感染者的合并症和多药治疗情况按年龄、性别和种族分层。

Comorbidity and polypharmacy among people with HIV stratified by age, sex, and race.

机构信息

Optum, Eden Prairie, MN, USA.

Merck & Co., Inc, Rahway, NJ, USA.

出版信息

HIV Res Clin Pract. 2024 Dec;25(1):2361176. doi: 10.1080/25787489.2024.2361176. Epub 2024 Jun 13.

Abstract

With an increase in life expectancy of people with HIV, there is a corresponding rise in comorbidities and consequent increases in comedications. This study compared comorbidity and polypharmacy among people with HIV and people without HIV stratified by age, sex, and race. This retrospective study utilised administrative claims data to identify adult people with HIV with antiretroviral therapy (ART) claims and HIV diagnosis codes from 01 January 2018 to 31 December 2018. Index date was the earliest ART claim or HIV diagnosis in the absence of ART claims. Inclusion required continuous enrolment for ≥12-month pre-index and ≥30-day post-index, along with ≥1 HIV diagnosis during baseline or follow-up. People with HIV were matched 1:2 with people without HIV on sociodemographic. Results were compared using z-tests with robust standard errors in an ordinary least squares regression or Rao-Scott tests. Study sample comprised 20,256 people with HIV and 40,512 people without HIV. Mean age was 52.3 years, 80.0% males, 45.9% Caucasian, and 28.5% African American. Comorbidities were significantly higher in younger age people with HIV than people without HIV. Female had higher comorbidity across all comorbidities especially younger age people with HIV. Polypharmacy was also significantly greater for people with HIV versus people without HIV across all age categories, and higher in females. Across races, multimorbidity and polypharmacy were significantly greater for people with HIV versus people without HIV. Comorbidities and polypharmacy may increase the risk for adverse drug-drug interactions and individualised HIV management for people with HIV across all demographics is warranted.

摘要

随着艾滋病毒感染者预期寿命的延长,合并症相应增加,相应的合并用药也随之增加。本研究比较了按年龄、性别和种族分层的艾滋病毒感染者和非艾滋病毒感染者的合并症和多药治疗情况。这项回顾性研究利用行政索赔数据,确定了 2018 年 1 月 1 日至 2018 年 12 月 31 日期间接受过抗逆转录病毒疗法 (ART) 治疗和艾滋病毒诊断的成年艾滋病毒感染者。索引日期是最早的 ART 索赔或无 ART 索赔情况下的艾滋病毒诊断。纳入标准要求在索引前至少 12 个月和索引后至少 30 天内持续注册,并且在基线或随访期间至少有 1 次艾滋病毒诊断。根据社会人口统计学对艾滋病毒感染者进行了 1:2 配对。使用具有稳健标准误差的普通最小二乘回归或 Rao-Scott 检验对结果进行了比较。研究样本包括 20256 名艾滋病毒感染者和 40512 名非艾滋病毒感染者。平均年龄为 52.3 岁,80.0%为男性,45.9%为白种人,28.5%为非裔美国人。与非艾滋病毒感染者相比,年轻的艾滋病毒感染者的合并症明显更高。女性在所有合并症中,特别是年轻的艾滋病毒感染者中,合并症更高。在所有年龄组中,艾滋病毒感染者的多药治疗也明显高于非艾滋病毒感染者,女性更高。在所有种族中,艾滋病毒感染者的合并症和多药治疗明显高于非艾滋病毒感染者。合并症和多药治疗可能会增加艾滋病毒感染者发生药物相互作用的风险,需要对所有人群的艾滋病毒感染者进行个体化的艾滋病毒管理。

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