Comorbid diseases and conditions in people with HIV in the UK

Abstract

Objectives

This study aimed to characterize the risk of people living with HIV (PLHIV) in the UK progressing to pre-specified HIV-associated comorbidities, compared with matched, HIV-negative controls.

Methods

Primary and secondary care records from the Clinical Practice Research Datalink (CPRD) and linked Hospital Episode Statistics (HES) were used to identify PLHIV, and a matched cohort from the HIV-negative population. Kaplan Meier curves and Cox proportional hazard models were used to evaluate the risk of developing comorbidities including central nervous system (CNS) disorders, end-stage renal disease, osteoporosis, diabetes, cardiovascular disease (CVD), hypertension, stroke and cancer.

Results

A total of 2945 PLHIV were matched to a cohort of 5890 HIV-negative controls. PLHIV demonstrated an increased hazard ratio (HR) for time to development of incident sleep disorders, depression, osteoporosis, stroke, cancer and renal disease when compared with their matched HIV-negative control. The HRs for anxiety, hypertension, diabetes and CVD were not significantly increased.

Conclusions

PLHIV in the UK were at a higher risk of developing a number of comorbid conditions, highlighting the need for regular attendance of health reviews such as the annual health reviews recommended by the British HIV Associations (BHIVA) quality standard for care, which are currently not uniformly conducted.

Keywords:

• HIV
• depression
• sleep disorders
• cardiovascular diseases
• cancer

Transparency

Declaration of funding

This work was funded by Gilead Sciences Ltd.

Declaration of financial/other relationships

B.I.J. and M.J.T. have disclosed that they are employed by Pharmatelligence, a research consultancy receiving funding from Gilead Sciences Ltd for the submitted work. C.J.C. has disclosed that he is a director of Pharmatelligence. C.V.M., L.S., D.F. and S.F. have disclosed that they are employed by Gilead Science Ltd. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors contributed to the study design and writing of the manuscript. B.I.J. and M.J.T. conducted the statistical analyses.

Data availability statement

This study is based in part on data from the Clinical Practice Research Datalink obtained under licence from the UK medicines and Healthcare products Regulatory Agency. The data is provided by patients and collected by the NHS as part of their care and support. HES data Copyright © (2018), re-used with the permission of The Health & Social Care Information Centre. All rights reserved. The interpretation and conclusions contained in this study are those of the authors alone.