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HIV infection and care pathway: From guidelines to clinical practice
I Poizot-Martin1, V Obry-Roguet2, O Zaegel-Faucher2
1Service d'immuno-hématologie clinique, Aix-Marseille université, AP-HM hôpital Sainte-Marguerite, 13009 Marseille, France; INSERM, IRD, SESSTIM, sciences économiques & Sociales de la Santé & Traitement de l'Information Médicale, AP-HM Sainte-Marguerite, service d'Immuno-hématologie clinique, biostatistique et technologies de l'information et de la communication, Aix Marseille Université, AP-HM, 13009 Marseille, France.
Insights
Personalized care for HIV patients requires frequent medical visits, especially for managing comorbidities. A multidisciplinary approach within one facility can effectively address these complex health needs.
Area of Science:
- Infectious Diseases
- Public Health
- Geriatrics
Background:
- HIV infection is a chronic condition requiring ongoing management.
- Aging HIV-positive populations present complex comorbidity profiles.
- Current care models may not adequately address the multifaceted needs of HIV patients.
Purpose of the Study:
- To quantify medical visits and procedures for HIV patients based on comorbidities and risk factors.
- To develop a personalized care pathway for HIV-infected individuals.
- To inform the implementation of tailored healthcare strategies.
Main Methods:
- Retrospective study of 915 HIV patients from 2016.
- Algorithm developed based on national HIV management guidelines.
- Comorbidity frequency analyzed by gender, transmission risk, and nadir CD4 count.
Main Results:
- 74.5% of patients had at least one comorbidity, increasing with age and lower CD4 counts.
- An average of six consultations/year/patient needed for comorbidity management.
- 53% of patients required proctology consultations; 5115 procedures estimated.
Conclusions:
- Personalized, multidisciplinary management in a single facility is a suitable model for HIV care.
- This approach can effectively address the complex health needs of HIV-infected individuals.
- Data supports optimizing resource allocation for HIV patient management.
Objectives:
To quantify within a cohort of HIV-infected individuals the number of medical visits and procedures to be carried out according to comorbidities and risk factors to implement a personalized care pathway.
Patients And Methods:
Retrospective study of 915 patients consulting from January 1 to December 31, 2016 at an outpatient unit of multidisciplinary consultations, using an electronic patient record. We built an algorithm using parameters required for the application of the national guidelines for the management of HIV-infected individuals. The frequency of comorbidities was measured according to gender, transmission risk group, and nadir CD4 (
Results:
Patients were mostly men (median age: 52 years), of whom 16% were aged≥60 years. Viral load was<40 copies/mL in 93.5% of treated patients and CD4 cell count≥500/mm3 for 73%. Overall, 74.5% of patients had at least one comorbidity. The number of comorbidities was similar in men and women but was significantly higher in patients with a nadir CD4 <200/mm3 and increased with age (irrespective of gender). The minimum number of consultations to be scheduled per year was 8123: 70% for the management of comorbidities with an average of six consultations/year/patient. Overall, 53% of patients should attend a proctology consultation. The minimum number of paramedical procedures to be performed was 5115.
Conclusion:
The implementation of a personalized multidisciplinary management within a single facility seems to be a suitable care model to address the needs of HIV-infected individuals.
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