Temporal network analysis of comorbidities among people with HIV in South Carolina

People with HIV experience a high rate of comorbidities that can complicate their health outcomes. Understanding the prevalence, interrelationships and temporal development of these comorbidities is crucial for improving health management and quality of life for people with HIV.

We used a population-based cohort extracted from statewide electronic health record (EHR) data in South Carolina (SC), including 18 649 people with HIV who survived at least 1 year after HIV diagnosis between January 1, 2005, and December 31, 2020. Comorbidities and organ systems were classified using ICD-10 codes. Network analysis was performed to assess the closeness centrality among comorbidities. Temporal network analysis was conducted every 3 years to compare the increases or decreases in comorbidities over time.

The most common comorbidities included infectious diseases (74.4% such as candidiasis, Hepatitis C and other sexually transmitted infections [STIs]), digestive system disorders (67.9%), mental and behavioural disorders (65.0%), respiratory system disorders (62.9%) and musculoskeletal system disorders (62.3%). The most frequent non-communicable conditions were hypertensive disorders (54.7%), nicotine dependence (54.3%), back pain (41.1%), anaemias (39.7%) and gastro-oesophageal reflux disease (GERD) (26.0%). The temporal analysis showed a rise in 10 comorbidities from 2006 to 2020, including hypertensive disease (19.7% to 24.7%) and dyslipidaemia (4.5% to 11.2%). Nicotine dependence, hypertensive disease, anaemia and major depressive disorder were the most prevalent over time.

Our study underscores the high prevalence and complex interrelationships of comorbidities among people with HIV in SC. This emphasizes the need for ongoing monitoring and specific interventions to address comorbidities, focusing on shared risk factors and established pathological pathways.