A Comparison of Comorbidities and their Contribution to Medical Resource Utilization for Matched HIV-Infected and Uninfected Individuals: A Cross-Sectional Analysis
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Abstract
HIV long-term survivorship is characterized by higher rates of comorbidities compared to uninfected groups. Aging with HIV involves complex interactions of factors (e.g., Individual Characteristics, Infections) that result in a 20% increase in comorbidity risk. With over half of the 1.1 million people living with HIV in the US age 50 and over, the need exists to further understand this interplay and differences in aging-related outcomes. Electronic health record data was analyzed for HIV infected (N=208) and uninfected (N=208) adult inpatients, propensity score matched by age and gender. Diagnostic codes were extracted that comprise the factors of Individual Characteristics, High Risk Behaviors, Chronic Conditions, Mental Health Conditions and Infections. Identified codes were assessed for their contributions to medical resource utilization, based on Charlson Comorbidity scores. Significant contributors to high Charslon scores for HIV infected patients were age (β=0.116; [95% CI 0.077, 0.155]) and admission frequency (β=0.159; [95% CI 0.114, 0.205]) in addition to the comorbidities of acute kidney failure (β=3.27; [95% CI 1.76, 4.78]), hypertension (β= −1.77; [95% CI −2.99, −0.551]). Significant contributors for HIV uninfected patients were age (β=0.110; [95% CI 0.087, 0.133]), length of hospital stay (β=0.006; [95% CI 0.003, 0.009]), acute kidney failure (β=1.556; [95% CI 0.611, 2.50]), heart failure (β= 1.713; [95% CI 0.717, 2.71]), and diabetes mellitus II (β= 1.385; [95% CI 0.634, 2.14]). Our findings enhance the understanding of the contributions to medical resource utilization based on HIV status and can inform intervention efficacy for improved HIV aging outcomes.
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