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Observational Study
. 2018 Jun 14;8(6):e019985.
doi: 10.1136/bmjopen-2017-019985.

Comorbidities and the use of comedications in people living with HIV on antiretroviral therapy in Japan: a cross-sectional study using a hospital claims database

Daniel J Ruzicka  1 , Kentaro Imai  2 , Kenichi Takahashi  3 , Toshio Naito  4
Affiliations
Observational Study

Comorbidities and the use of comedications in people living with HIV on antiretroviral therapy in Japan: a cross-sectional study using a hospital claims database

Daniel J Ruzicka et al. BMJ Open. .

Abstract

Objectives: To investigate the prevalence of chronic comorbidities and the use of comedications in people living with HIV (PLWH) and on antiretrovirals in Japan, by using a hospital claims database.

Design: Observational, retrospective, cross-sectional study.

Setting: A hospital claims database of Japanese hospitals that have advanced medical treatment capabilities (ie, advanced treatment hospitals, general hospitals, acute care hospitals), which include those providing acute and chronic care (excluding nursing homes or hospices).

Participants: A total of 1445 PLWH aged ≥18 years and with a prescription record of antiretrovirals between January 2010 and December 2015 were identified from the database.

Outcome measures: The number and types of chronic comorbidities, as well as the number and types of comedications, in different age groups of the PLWH.

Results: The median (range) age of patients was 45 (18-90) years, and 90.4% were men. Of the 1445 patients, 972 (67.3%) had at least one chronic comorbidity. Common chronic comorbidities included lipid disorders (31.6%), diabetes (26.8%), hypertension (18.2%) and hepatitis B/C coinfection (18.2%). Patients in the older age groups had greater numbers of chronic comorbidities. The most common chronic comorbidities in the older age groups were hypertension, diabetes and lipid disorders. The majority of patients used at least one comedication, and those in the older age groups used greater numbers of comedications. The most common therapeutic category of comedication included antacids, antiflatulents and antiulcerants (31.7%). Of 151 malignancies reported in 117 patients, 84 were AIDS-defining cancers and 67 were non-AIDS-defining cancers.

Conclusions: Chronic comorbidities and comedications were common among PLWH in Japan taking antiretrovirals; particularly among older patients, who more frequently used comedications. This suggests the need for giving special attention to the appropriate management of this patient population.

Keywords: HIV; Japan; comorbidity; epidemiology; infectious disease; polypharmacy.

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Conflict of interest statement

Competing interests: DJR, KI and KT are employees of MSD K.K., Tokyo, Japan. TN has received no funding for this study but received lecture fees from MSD K.K., Tokyo, Japan.

Figures

Figure 1
Figure 1
Age and sex distribution of studied patients living with HIV (n=1445).
Figure 2
Figure 2
Number and type of chronic comorbidities by age group. *P<0.0001 under the Cochran-Armitage trend test.
Figure 3
Figure 3
(A) Number of comedications prescribed by age group. (B) The top five common comedications by age group.
Figure 4
Figure 4
Proportions of studied patients with AIDS-defining cancers and non-AIDS-defining cancers among patients with any malignancies within each age group.
See this image and copyright information in PMC

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