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Clinical characteristics and treatment patterns among US patients with HIV

Julie L Priest1, Tanya Burton, Cori Blauer-Peterson

  • 1ViiV Healthcare, 5 Moore Dr, Durham, NC 27709.

The American Journal of Managed Care
|December 21, 2019
PubMed

Insights

People with HIV-1 and Medicare insurance face higher pill burdens and more comorbidities. Treatment selection for HIV-1 should consider individual patient complexities like comorbidities and pill burden.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Health Services Research

Background:

  • Antiretroviral therapy (ART) has transformed HIV-1 management, improving life expectancy and quality of life.
  • Understanding treatment patterns and clinical characteristics in diverse patient populations is crucial for optimizing care.
  • Health insurance type can influence access to and patterns of care for chronic conditions like HIV-1.

Purpose of the Study:

  • To describe the clinical characteristics and treatment patterns of patients with HIV-1.
  • To compare these characteristics between patients with commercial insurance and those with Medicare in the United States.
  • To identify factors influencing treatment complexity, such as comorbidities and pill burden.

Main Methods:

  • Retrospective cohort study utilizing administrative claims data from 2007 to 2017.
  • Included adult commercial and Medicare health plan enrollees with evidence of HIV-1 and ART.
  • Identified ART regimens using a claims-based algorithm and stratified results by treatment status and insurance type.

Main Results:

  • A cohort of 18,699 patients with HIV-1 was analyzed; 82% had commercial insurance.
  • Patients with Medicare insurance or multiple ART regimens experienced a higher daily pill burden.
  • Common comorbidities included hyperlipidemia, cardiovascular disease, hypertension, depression, and anxiety.

Conclusions:

  • Patients with HIV-1 enrolled in Medicare exhibit significant comorbidities and a high total pill burden.
  • Effective HIV-1 management requires consideration of individual complexities, including comorbidities and pill burden, when selecting ART regimens.
  • Despite advancements in ART, personalized treatment approaches are essential for improving outcomes in people living with HIV.
Abstract

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