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墨西哥艾滋病毒感染者和癌症患者的多重疾病。

Multimorbidity in people living with HIV and cancer in Mexico.

机构信息

Departamento de Medicina Interna, Hospital Regional de Alta Especialidad, Infectología, Tuxtla Gutierrez.

Departamente de Infectología, Instituto Nacional de Cancerología, Infectología, Mexico City. Mexico.

出版信息

Gac Med Mex. 2024;160(2):144-153. doi: 10.24875/GMM.M24000888.

Abstract

BACKGROUND

The proportion of older people living with HIV (PLWH) has increased. Non-communicable diseases occur earlier in PLWH than in the general population.

OBJECTIVE

The goal of this study was to estimate the prevalence of comorbidities in PLWH and cancer in a tertiary referral center in Mexico City.

MATERIAL AND METHODS

In this retrospective study, we included PLWH > 40 years with a history of cancer, coming to Instituto Nacional de Cancerologia from 2010 through 2019. All patients needed to be on antiretrovirals for at least six months. Data collected included cancer type, comorbidities, frequency of polypharmacy, FRAX score and 10-year cardiovascular risk. Patients were evaluated for depression with the Beck Inventory Depression-II Scale. Variables associated to multimorbidity (2 or more comorbidities) were evaluated.

RESULTS

Of 125 patients, 69% had at least one comorbidity; 32% had ≥ 2. Common comorbidities were dyslipidemia (54%), hypertension (19%), obesity (14%) and Diabetes (12%). In patients ≥ 50 years, 29 (62%) already undergone a densitometry and 9 (31%) had osteoporosis; 56 depression questionnaires were used: 30% had mild-to-severe depression. Being ≥ 50 years was associated with multimorbidity (aOR 2.57 (1.18-5.58), p = 0.017).

CONCLUSIONS

A high prevalence of multimorbidity and poor screening of bone disease and mental health is reported in patients with PLWH and cancer. A holistic approach to the PLWH in the Infectious Diseases consultation is needed to improve the detection and management of non-communicable diseases, to go beyond viral suppression and towards an improved quality of life.

摘要

背景

感染艾滋病毒(HIV)的老年人(PLWH)的比例有所增加。与普通人群相比,PLWH 中非传染性疾病的发病更早。

目的

本研究旨在评估墨西哥城一家三级转诊中心的 PLWH 和癌症患者的合并症患病率。

材料和方法

在这项回顾性研究中,我们纳入了 2010 年至 2019 年期间在国家癌症研究所就诊的年龄>40 岁、有癌症病史且至少服用六个月抗逆转录病毒药物的 PLWH。收集的数据包括癌症类型、合并症、多药治疗频率、FRAX 评分和 10 年心血管风险。采用 Beck 抑郁量表 II 评估患者的抑郁情况。评估与多种合并症(两种或两种以上合并症)相关的变量。

结果

在 125 名患者中,69%至少有一种合并症;32%有≥2 种合并症。常见的合并症包括血脂异常(54%)、高血压(19%)、肥胖(14%)和糖尿病(12%)。在≥50 岁的患者中,29 人(62%)已进行过骨密度检查,9 人(31%)患有骨质疏松症;共使用了 56 份抑郁问卷:30%有轻至重度抑郁。≥50 岁与多种合并症相关(优势比 2.57(1.18-5.58),p=0.017)。

结论

本研究报告了 HIV 合并癌症患者存在多种合并症和骨病及心理健康筛查不足的情况。传染病咨询中需要对 PLWH 采取整体方法,以改善非传染性疾病的检测和管理,超越病毒抑制,提高生活质量。

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