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. 2020 Dec 1:31:100665.
doi: 10.1016/j.eclinm.2020.100665. eCollection 2021 Jan.

Prospective association of social circumstance, socioeconomic, lifestyle and mental health factors with subsequent hospitalisation over 6-7 year follow up in people living with HIV

Sophia M Rein  1 , Colette J Smith  1 , Clinton Chaloner  1 , Adam Stafford  2 , Alison J Rodger  1 , Margaret A Johnson  2 , Jeffrey McDonnell  1 , Fiona Burns  1   2 , Sara Madge  2 , Alec Miners  3 , Lorraine Sherr  1 , Simon Collins  4 , Andrew Speakman  1 , Andrew N Phillips  1 , Fiona C Lampe  1
Affiliations

Prospective association of social circumstance, socioeconomic, lifestyle and mental health factors with subsequent hospitalisation over 6-7 year follow up in people living with HIV

Sophia M Rein et al. EClinicalMedicine. .

Abstract

Background: Predictors of hospitalisation in people with HIV (PLHIV) in the contemporary treatment era are not well understood.

Methods: This ASTRA sub-study used clinic data linkage and record review to determine occurrence of hospitalisations among 798 PLHIV from baseline questionnaire (February to December 2011) until 1 June 2018. Associations of baseline social circumstance, socioeconomic, lifestyle, mental health, demographic and clinical factors with repeated all-cause hospitalisation from longitudinal data were investigated using Prentice-Williams-Peterson models. Associations were also assessed in 461 individuals on antiretroviral therapy (ART) with viral load ≤50 copies/ml and CD4 count ≥500 cells/ µl.

Findings: Rate of hospitalisation was 5.8/100 person-years (95% CI: 5.1-6.5). Adjusted for age, demographic group and time with diagnosed HIV, the following social circumstance, socioeconomic, lifestyle and mental health factors predicted hospitalisation: no stable partner (adjusted hazard ratio (aHR)=1.59; 95% CI=1.16-2.20 vs living with partner); having children (aHR=1.50; 1.08-2.10); non-employment (aHR=1.56; 1.07-2.27 for unemployment; aHR=2.39; 1.70-3.37 for sick/disabled vs employed); rented housing (aHR=1.72; 1.26-2.37 vs homeowner); not enough money for basic needs (aHR=1.82; 1.19-2.78 vs enough); current smoking (aHR=1.39; 1.02-1.91 vs never); recent injection-drug use (aHR=2.11; 1.30-3.43); anxiety symptoms (aHRs=1.39; 1.01-1.91, 2.06; 1.43-2.95 for mild and moderate vs none/minimal); depressive symptoms (aHRs=1.67; 1.17-2.38, 1.91; 1.30-2.78 for moderate and severe vs none/minimal); treated/untreated depression (aHRs=1.65; 1.03-2.64 for treated depression only, 1.87; 1.39-2.52 for depressive symptoms only; 1.53; 1.05-2.24; for treated depression and depressive symptoms, versus neither). Associations were broadly similar in those with controlled HIV and high CD4.

Interpretation: Social circumstance, socioeconomic disadvantage, adverse lifestyle factors and poorer mental health are strong predictors of hospitalisation in PLHIV, highlighting the need for targeted interventions and care.

Funding: British HIV Association (BHIVA) Research Award (2017); SMR funded by a PhD fellowship from the Royal Free Charity.

Keywords: AIDS; HIV; Hospitalization; Mental health; Socioeconomic factors.

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Conflict of interest statement

CS reports grants from ViiV Healthcare and personal fees from Gilead Sciences outside the submitted work; SR reports a PhD stipend from the Royal Free Charity but no conflicts of interest exist. All other authors have no conflicts of interest to declare related to the submitted work.

Figures

Fig. 1
Fig. 1
Crude rates of hospitalisation and 95% confidence intervals (CI) according to a.) social circumstance, b.) socioeconomic, c.) lifestyle and d.) mental health factors. Pyrs=person-years.
Fig. 1
Fig. 1
Crude rates of hospitalisation and 95% confidence intervals (CI) according to a.) social circumstance, b.) socioeconomic, c.) lifestyle and d.) mental health factors. Pyrs=person-years.
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References

    1. Nosyk B., Lima V., Colley G., Yip B., Hogg R.S., Montaner J.S. Costs of health resource utilization among HIV-positive individuals in British Columbia, Canada: results from a population-level study. Pharmacoeconomics. 2015;33(3):243–253. - PMC - PubMed
    1. Leon-Reyes S., Schafer J., Fruh M., Schwenkglenks M., Reich O., Schmidlin K. Cost estimates for HIV care and patient characteristics for health resource utilisation from linkage of claims data with the Swiss HIV Cohort Study. Clin Infect Dis. 1 March 2019;Volume 68(Issue 5):827–833. doi: 10.1093/cid/ciy564. - DOI - PubMed
    1. Palella F.J., Jr., Delaney K.M., Moorman A.C., Loveless M.O., Fuhrer J., Satten G.A. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV outpatient study investigators. N Engl J Med. 1998;338(13):853–860. - PubMed
    1. Bellino S., Borghetti A., Lombardi F., Camoni L., Ciccullo A., Baldin G. Trends of hospitalisations rates in a cohort of HIV-infected persons followed in an Italian hospital from 1998 to 2016. Epidemiol Infect. 2019;147:e89. - PMC - PubMed
    1. Ford N., Shubber Z., Meintjes G., Grinsztejn B., Eholie S., Mills E.J. Causes of hospital admission among people living with HIV worldwide: a systematic review and meta-analysis. Lancet HIV. 2015;2(10):e438–e444. - PubMed

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