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Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes

Alan Winston1,2, Davide De Francesco3, Frank Post4

  • 1Department of Infectious Disease, Faculty of Medicine, Imperial College London.

AIDS (London, England)
|August 1, 2020
PubMed

Insights

People with HIV (PWH) have higher comorbidity indices than HIV-negative individuals, though the differences are small. The Elixhauser Comorbidity Index was higher in PWH, potentially impacting COVID-19 outcomes.

Area of Science:

  • Medical research
  • Public health
  • Epidemiology

Background:

  • HIV infection can affect long-term health and increase the risk of comorbidities.
  • Understanding comorbidity burden in people with HIV (PWH) is crucial for comprehensive care.
  • Previous studies suggest PWH may experience accelerated aging and increased non-AIDS-related conditions.

Purpose of the Study:

  • To compare comorbidity indices between people with HIV (PWH) and similar HIV-negative controls.
  • To assess the magnitude of differences in comorbidity burden using established indices.

Main Methods:

  • Cross-sectional analysis of the "Pharmacokinetic and clinical Observations in PeoPle over fiftY" cohort.
  • Comparison of Elixhauser Comorbidity Index (ECI), Charlson Comorbidity Index, and Comorbidity Burden Index between PWH and controls.
  • Statistical analysis using Mann-Whitney U test and effect size calculation.

Main Results:

  • The study included 699 PWH and 304 HIV-negative controls, predominantly male and white.
  • All three comorbidity indices were significantly higher in PWH compared to controls (P < 0.001).
  • Effect sizes for the differences were small to medium, ranging from 0.18 to 0.38.

Conclusions:

  • People with HIV (PWH) exhibit higher comorbidity indices than HIV-negative controls.
  • The observed differences, while statistically significant, were of small to medium magnitude.
  • Elevated ECI in PWH may be linked to increased prevalence at the higher end of the index range, potentially influencing outcomes like COVID-19.
Abstract

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