Patterns of Co-occurring Comorbidities in People Living With HIV

被引：36

作者：

De Francesco, Davide ^{[1
]}

Verboeket, Sebastiaan O. ^{[2
,3
,15
,16
]}

Underwood, Jonathan ^{[4
,12
]}

Bagkeris, Emmanouil ^{[1
]}

Wit, Ferdinand W. ^{[2
,3
]}

Mallon, Patrick W. G. ^{[5
]}

Winston, Alan ^{[4
,12
]}

Reiss, Peter ^{[2
,3
]}

Sabin, Caroline A. ^{[1
]}

Babalis, Daphne ^{[13
]}

Boffito, Marta ^{[7
]}

Burgess, Laura ^{[13
]}

Mallon, Paddy ^{[10
]}

Post, Frank ^{[9
]}

Sachikonye, Memory

Anderson, Jane ^{[8
]}

Asboe, David ^{[7
]}

Garvey, Lucy ^{[12
]}

Pozniak, Anton ^{[7
]}

Vera, Jaime ^{[6
]}

Williams, Ian ^{[11
]}

Clarke, Amanda ^{[6
]}

Bexley, Andrew ^{[6
]}

Richardson, Celia ^{[6
]}

Kirk, Sarah ^{[6
]}

Gleig, Rebecca ^{[6
]}

Bracchi, Margherita ^{[7
]}

Pagani, Nicole ^{[7
]}

Cerrone, Maddalena ^{[7
]}

Bradshaw, Daniel ^{[7
]}

Ferretti, Francesca ^{[7
]}

Higgs, Chris ^{[7
]}

Seah, Elisha ^{[7
]}

Fletcher, Stephen ^{[7
]}

Anthonipillai, Michelle ^{[7
]}

Moyes, Ashley ^{[7
]}

Deats, Katie ^{[7
]}

Syed, Irtiza ^{[7
]}

Matthews, Clive ^{[7
]}

Fernando, Peter ^{[7
]}

Chiwome, Chido ^{[7
]}

Hardwick, Shane ^{[7
]}

Mguni, Sifiso ^{[8
]}

Clark, Rebecca ^{[8
]}

Nevin-Dolan, Rhiannon ^{[8
]}

Pelluri, Sambasivarao ^{[8
]}

Campbell, Lucy ^{[9
]}

Yurdakul, Selin ^{[9
]}

Okumu, Sara ^{[9
]}

Pollard, Louise ^{[9
]}

机构：

[1] UCL, Inst Global Hlth, Royal Free Campus,Rowland Hill St, London NW3 2PF, England

[2] Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Global Hlth, Amsterdam, Netherlands

[3] Amsterdam Inst Global Hlth & Dev, Amsterdam, Netherlands

[4] Imperial Coll London, Div Infect Dis, London, England

[5] UCD Sch Med, Dublin, Ireland

[6] Brighton & Sussex Univ Hosp, Brighton, E Sussex, England

[7] Chelsea & Westminster Hosp, St Stephens Ctr, London, England

[8] Homerton Univ Hosp, Homerton Sexual Hlth Serv, London, England

[9] Kings Coll Hosp London, Caldecot Ctr, London, England

[10] Univ Coll Dublin, Sch Med, HIV Mol Res Grp, Dublin, Ireland

[11] UCL, Res Dept Infect & Populat Hlth, London, England

[12] Imperial Coll Healthcare NHS Trust, St Marys Hosp London, London, England

[13] Imperial Coll London, Imperial Clin Trials Unit, London, England

[14] Royal Free Hosp, Ian Charleson Day Ctr, London, England

[15] AMC, Dept Global Hlth, Amsterdam, Netherlands

[16] AIGHD, Amsterdam, Netherlands

[17] Publ Hlth Serv Amsterdam, Dept Infect Dis, Amsterdam, Netherlands

[18] HIV Monitoring Fdn, Amsterdam, Netherlands

[19] AMC, Lab Viral Immune Pathogenesis, Amsterdam, Netherlands

[20] AMC, Dept Expt Immunol, Amsterdam, Netherlands

[21] AMC, Div Infect Dis, Amsterdam, Netherlands

[22] AMC, Dept Cardiol, Amsterdam, Netherlands

[23] AMC, Div Endocrinol & Metab, Amsterdam, Netherlands

[24] Free Univ Med Ctr Amsterdam, Amsterdam, Netherlands

[25] AMC, Dept Gastroenterol, Amsterdam, Netherlands

[26] AMC, Div Geriatr Med, Amsterdam, Netherlands

[27] AMC, Div Nephrol, Amsterdam, Netherlands

[28] AMC, Dept Neurol, Amsterdam, Netherlands

[29] AMC, Dept Ophthalmol, Amsterdam, Netherlands

[30] AMC, Dept Psychiat, Amsterdam, Netherlands

[31] Free Univ Med Ctr, Dept Psychiat, Amsterdam, Netherlands

[32] AMC, Dept Med Psychol, Amsterdam, Netherlands

[33] AMC, Dept Pulm Med, Amsterdam, Netherlands

[34] AMC, Dept Radiol, Amsterdam, Netherlands

[35] AMC, Dept Gynaecol, Amsterdam, Netherlands

[36] AMC, Div Vasc Med, Amsterdam, Netherlands

[37] HIV Vereniging Nederland, Amsterdam, Netherlands

来源：

OPEN FORUM INFECTIOUS DISEASES | 2018年 / 5卷 / 11期

关键词：

comorbidities; HIV; multimorbidity; patterns of comorbidities; MULTIMORBIDITY PATTERNS; HEALTH CONDITIONS; MENTAL-HEALTH; OLDER AGE; RISK; PREVALENCE;

D O I：

10.1093/ofid/ofy272

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. The aims of this study were to identify common patterns of comorbidities observed in people living with HIV (PLWH), using a data-driven approach, and evaluate associations between patterns identified. Methods. A wide range of comorbidities were assessed in PLWH participating in 2 independent cohorts (POPPY: UK/Ireland; AGE(h)IV: Netherlands). The presence/absence of each comorbidity was determined using a mix of self-reported medical history, concomitant medications, health care resource use, and laboratory parameters. Principal component analysis (PCA) based on Somers' D statistic was applied to identify patterns of comorbidities. Results. PCA identified 6 patterns among the 1073 POPPY PLWH (85.2% male; median age [interquartile range {IQR}], 52 [47-59] years): cardiovascular diseases (CVDs), sexually transmitted diseases (STDs), mental health problems, cancers, metabolic disorders, chest/other infections. The CVDs pattern was positively associated with cancer (r = .32), metabolic disorder (r = .38), mental health (r = .16), and chest/other infection (r = .17) patterns (all P < .001). The mental health pattern was correlated with all the other patterns (in particular cancers: r = .20; chest/other infections: r = .27; both P < .001). In the 598 AGE(h)IV PLWH (87.6% male; median age [IQR], 53 [48-59] years), 6 patterns were identified: CVDs, chest/liver, HIV/AIDS events, mental health/neurological problems, STDs, and general health. The general health pattern was correlated with all the other patterns (in particular CVDs: r = .14; chest/liver: r = .15; HIV/AIDS events: r = .31; all P < .001), except STDs (r = -.02; P = .64). Conclusions. Comorbidities in PLWH tend to occur in nonrandom patterns, reflecting known pathological mechanisms and shared risk factors, but also suggesting potential previously unknown mechanisms. Their identification may assist in adequately addressing the pathophysiology of increasingly prevalent multimorbidity in PLWH.

引用

页数：10

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