Yu Biao, Ren Ningjun, Xiao Ticheng, Chen Jinyu, Pi Zhiwen, He Lingxi, Zhang Jingbo, Zou Huachun, Li Ailing, Chen Run, Chen Xiaoxue, Chen Yanhua, Huang Fuli, Chen Hang, Fan Song
School of Public Health Southwest Medical University Luzhou Sichuan China.
Luzhou Center for Disease Control and Prevention Luzhou Sichuan China.
J Am Heart Assoc. 2025 May 20;14(10):e040634. doi: 10.1161/JAHA.124.040634. Epub 2025 May 13.
The increasing life expectancy among people living with HIV (PLWH) has transformed HIV management into chronic disease care. This transformation has introduced complex patterns of comorbidities that challenge current health care approaches. A deeper understanding of the interactions between these conditions and their distribution across demographic groups remains essential for optimizing care.
This study analyzed electronic health records of 13 884 adult people living with HIV in Luzhou, China (2001-2022). Network analysis identified central comorbidities and their interactions. Hierarchical clustering revealed disease patterns, while time series analysis tracked temporal trends. A nomogram-based prediction model underwent development and validation using bootstrap resampling.
The analysis identified comorbidities in 34.58% of the cohort. Network analysis revealed hypertension as the most central condition (Strength: 0.30, Betweenness: 82, Closeness: 0.0007), followed by metabolic disorders and peripheral vascular diseases. Four distinct comorbidity clusters emerged, with infectious and metabolic diseases forming the core cluster. Demographic patterns showed that younger, female, and homosexual people living with HIV exhibited patterns dominated by neoplasms and sexually transmitted diseases, contrasting with cardiovascular-metabolic patterns in older, male, and heterosexual individuals. Age >50 years (odds ratio, 2.220 [95% CI, 2.024-2.436]) and male sex (odds ratio, 1.145 [95% CI, 1.053-1.246]) emerged as significant predictors of comorbidity risk. The prediction model demonstrated acceptable calibration (=13.784, =0.088) and discrimination (AUC, 0.666 [95% CI, 0.657-0.675]).
The findings establish hypertension as a central node in HIV comorbidity networks, with patterns varying by demographic characteristics. This evidence-based framework supports the development of targeted screening strategies and personalized interventions focused on central network conditions.
艾滋病毒感染者（PLWH）预期寿命的增加已将艾滋病毒管理转变为慢性病护理。这种转变带来了复杂的合并症模式，对当前的医疗保健方法构成了挑战。深入了解这些疾病之间的相互作用及其在不同人口群体中的分布情况对于优化护理仍然至关重要。
本研究分析了中国泸州13884名成年艾滋病毒感染者（2001 - 2022年）的电子健康记录。网络分析确定了核心合并症及其相互作用。层次聚类揭示了疾病模式，而时间序列分析跟踪了时间趋势。使用自助重采样对基于列线图的预测模型进行了开发和验证。
分析确定该队列中34.58%的人患有合并症。网络分析显示高血压是最核心的疾病（强度：0.30，中介中心性：82，接近中心性：0.0007），其次是代谢紊乱和外周血管疾病。出现了四个不同的合并症集群，感染性和代谢性疾病构成了核心集群。人口统计学模式表明，年轻、女性和同性恋艾滋病毒感染者的疾病模式以肿瘤和性传播疾病为主，这与老年、男性和异性恋个体的心血管 - 代谢模式形成对比。年龄>50岁（比值比，2.220 [95%置信区间，2.024 - 2.436]）和男性（比值比，1.145 [95%置信区间，1.053 - 1.246]）是合并症风险的重要预测因素。预测模型显示出可接受的校准（=13.784，=0.088）和区分度（AUC，0.666 [95%置信区间，0.657 - 0.675]）。
研究结果确定高血压是艾滋病毒合并症网络中的核心节点，其模式因人口统计学特征而异。这一基于证据的框架支持制定针对核心网络疾病的靶向筛查策略和个性化干预措施。
