Cited by 213HIV-related health complications and treatmentsHIV/AIDS Research and InterventionsChronic Disease Management Strategies

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A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario

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Kendall, Claire E, Wong, Jenna, Taljaard, Monica, Glazier, Richard H, Hogg, William, Younger, Jaime, Manuel, Douglas G·2014·BMC Public Health

DOI 10.1186/1471-2458-14-161PMC PMC3933292

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Abstract

BACKGROUND: As people diagnosed with HIV and receiving combination antiretroviral therapy are now living longer, they are likely to acquire chronic conditions related to normal ageing and the effects of HIV and its treatment. Comordidities for people with HIV have not previously been described from a representative population perspective. METHODS: We used linked health administrative data from Ontario, Canada. We applied a validated algorithm to identify people with HIV among all residents aged 18 years or older between April 1, 1992 and March 31, 2009. We randomly selected 5 Ontario adults who were not identified with HIV for each person with HIV for comparison. Previously validated case definitions were used to identify persons with mental health disorders and any of the following physical chronic diseases: diabetes, congestive heart failure, acute myocardial infarction, stroke, hypertension, asthma, chronic obstructive lung disease, peripheral vascular disease and end-stage renal failure. We examined multimorbidity prevalence as the presence of at least two physical chronic conditions, or as combined physical-mental health multimorbidity. Direct age-sex standardized rates were calculated for both cohorts for comparison. RESULTS: 34.4% (95% confidence interval (CI) 33.6% to 35.2%) of people with HIV had at least one other physical condition. Prevalence was especially high for mental health conditions (38.6%), hypertension (14.9%) and asthma (12.7%). After accounting for age and sex differences, people with HIV had significantly higher prevalence of all chronic conditions except myocardial infarction and hypertension, as well as substantially higher multimorbidity (prevalence ratio 1.30, 95% CI 1.18 to 1.44) and combined physical-mental health multimorbidity (1.79, 95% CI 1.65 to 1.94). Prevalence of multimorbidity among people with HIV increased with age. The difference in prevalence of multimorbidity between the two cohorts was more pronounced among women. CONCLUSION: People living with HIV in Ontario, especially women, had higher prevalence of comorbidity and multimorbidity than the general population. Quantifying this morbidity at the population level can help inform healthcare delivery requirements for this complex population.

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Figure 1 Flow diagram for study cohorts.CC BY · PubMed Central

Figure 2 Morbidity prevalence by age group among men and women with HIV versus the Ontario general population.CC BY · PubMed Central

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Authors: Kendall, C. E., Wong, J., Taljaard, M., Glazier, R. H., Hogg, W., Younger, J., & Manuel, D. G.
Affiliations: Bruyère (CA)
McGill University (CA)
University of Ottawa (CA)
University of Toronto (CA)
Ottawa Hospital Research Institute (CA)
Corresponding author: Kendall, Claire E
ORCID: Kendall, Claire E
Wong, Jenna
Taljaard, Monica
Glazier, Richard H
Hogg, William
Manuel, Douglas G
Venue: BMC Public Health
Publisher: Springer Science and Business Media LLC
Published: 2014-02-13
Volume: 14
Issue: 1
Pages: 161-161
ISSN: 1471-2458 (ISSN-L)
DOI: 10.1186/1471-2458-14-161
PMC: PMC3933292
OpenAlex: W2144007968
Cited by: 213
References: 45
Citations by year: 2026: 8 · 2025: 13 · 2024: 11 · 2023: 20 · 2022: 24 · 2021: 27 · 2020: 22 · 2019: 26 · 2018: 16 · 2017: 14 · 2016: 15 · 2015: 10 · 2014: 6
FWCI: 16.06
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
www.springer.com/tdm (unspecified)
Locations: BMC Public Health (publishedVersion, cc-by)
Europe PMC (PubMed Central) (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
uO Research (University of Ottawa) (submittedVersion, public-domain)
TSpace (University of Toronto) (submittedVersion)
Funders: University of Ottawa
Ottawa Hospital Research Institute
Public Health Agency of Canada
Institute for Clinical Evaluative Sciences
Ontario Ministry of Health and Long-Term Care
University of Toronto
Canadian Institutes of Health Research
Topics: Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords: HIV, multimorbidity, comorbidities, chronic disease, mental illness, hypertension, asthma, diabetes mellitus, women living with HIV, age differences, Ontario
MeSH terms: Adolescent, Adult, Aged, Aging, Chronic Disease, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Heart Failure, Humans, Hypertension, Kidney Failure, Chronic, Male, Middle Aged, Ontario, Retrospective Studies, Sex Factors, Cohort Studies, HIV Infections, Comorbidity, Prevalence

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A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario

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