Comorbidities and co-medications among 28 089 people living with HIV: A nationwide cohort study from 2009 to 2019 in Japan.

Abstract

OBJECTIVES:

Comorbidities are associated with a high burden of disease in people living with HIV (PLWH). The objective was to investigate the prevalence of chronic comorbidities and use of co-medications in PLWH in Japan.

METHODS:

This study retrospectively analysed clinical information from PLWH receiving antiretroviral therapy (ART) between April 2009 and March 2019. Demographic characteristics, numbers and types of chronic comorbidities, and numbers and types of non-ART co-medications, were described by age groups. The source of data was the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB).

RESULTS:

Overall, 28 089 PLWH (male 91.9%) who used ART were identified. Out of 28 089 PLWH, 81.5% had at least one chronic comorbidity. The numbers of AIDS-defining cancers and non-AIDS-defining cancers in this Japanese cohort were 2432 (8.7%) and 2485 (8.8%), respectively. The cumulative burden of comorbidities including non-AIDS-defining cancer increased with age. Changes in trend between 2009 and 2019 were observed, including a higher proportion of PLWH diagnosed at ≥ 70 years old [2019 (4.7%) vs. 2009 (2.4%)] and a decreasing percentage of patients with AIDS-defining cancers (down from 6.3% to 4.8% between 2009 and 2019). The most common co-medications during the most recent 3-month period were lipid-regulating/anti-atheroma preparations (11.3%), antacids, antiflatulents and anti-ulcerants (9.6%), and agents acting on the renin-angiotensin system (8.1%). The three most common therapeutic categories of co-medications during the study period were antacids, antiflatulents and anti-ulcerants (35.0%), systemic antihistamines (33.7%) and psycholeptics (27.1%). More than 30% of PLWH aged > 40 years used at least one co-medication in a 3-month period, while more than half of PLWH aged > 30 years had at least one co-medication prescribed concomitantly for a total of ≥ 90 days during the study period, and the numbers of co-medications used were greater in the older age groups.

CONCLUSIONS:

The burden of chronic comorbidities and co-medication were found to be greater in older, as compared to younger patients, among 28 089 PLWH in a nationwide study in Japan. This finding suggests the need to identify elderly PLWH and to appropriately manage their HIV and comorbidities.

• Authors: Toshio Naito, Mai Suzuki, Shinichi Fukushima, Mayumi Yuda, Nobuyuki Fukui, Shotaro Tsukamoto, Kazutoshi Fujibayashi, Keiko Goto-Hirano, Ryohei Kuwatsuru
• Journal: HIV medicine (HIV Med) Vol. 23 Issue 5 Pg. 485-493 (05 2022) ISSN: 1468-1293 [Electronic] England
• PMID: 34821006 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2021 The Authors. HIV Medicine published by John Wiley & Sons Ltd on behalf of British HIV Association.

Chemical References

• Antacids
• Antifoaming Agents

Topics

• Acquired Immunodeficiency Syndrome (drug therapy)
• Aged
• Antacids (therapeutic use)
• Antifoaming Agents (therapeutic use)
• Cohort Studies
• Comorbidity
• HIV Infections (complications, drug therapy, epidemiology)
• Humans
• Japan (epidemiology)
• Male
• Neoplasms (complications, epidemiology)
• Retrospective Studies