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. 2022 May 3;6(3):218-227.
doi: 10.1016/j.mayocpiqo.2022.03.004. eCollection 2022 Jun.

Multimorbidity Burden and Incident Heart Failure Among People With and Without HIV: The HIV-HEART Study

Matthew T Mefford  1 , Michael J Silverberg  2   3   4 , Thomas K Leong  2 , Rulin C Hechter  1   3   5 , William J Towner  1   6   7 , Alan S Go  2   3   4   8   9 , Michael Horberg  3   10 , Haihong Hu  10 , Teresa N Harrison  1 , Sue Hee Sung  2 , Kristi Reynolds  1   3
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Multimorbidity Burden and Incident Heart Failure Among People With and Without HIV: The HIV-HEART Study

Matthew T Mefford et al. Mayo Clin Proc Innov Qual Outcomes. .

Abstract

Objective: To examine the association between multimorbidity burden and incident heart failure (HF) among people with HIV (PWH) and people without HIV (PWoH).

Patients and methods: The HIV-HEART study is a retrospective cohort study that included adult PWH and PWoH aged 21 years or older at Kaiser Permanente between 2000 and 2016. Multimorbidity burden was defined by the baseline prevalence of 22 chronic conditions and was categorized as 0-1, 2-3, and 4 or more comorbidities on the basis of distribution of the overall population. People with HIV and PWoH were followed for a first HF event, all-cause death, or up to the end of follow-up on December 31, 2016. Using Cox proportional hazard regression, hazard ratios and 95% CIs were calculated to examine the association between multimorbidity burden and incident HF among PWH and PWoH, separately.

Results: The prevalences of 0-1, 2-3, and 4 or more comorbidities were 83.3%, 13.0%, and 3.7% in PWH (n=38,868), and 82.2%, 14.3%, and 3.5% in PWoH (n=386,586), respectively. After multivariable adjustment, compared with people with 0-1 comorbidities, the hazard ratios of incident HF associated with 2-3 and 4 or more comorbidities were 1.33 (95% CI, 1.04-1.71) and 2.41 (95% CI, 1.78-3.25) in PWH and 2.10 (95% CI, 1.92-2.29) and 4.09 (95% CI, 3.64-4.61) in PWoH, respectively.

Conclusion: Multimorbidity was associated with a higher risk of incident HF among PWH and PWoH, with more prominent associations in PWoH and certain patient subgroups. The identification of specific multimorbidity patterns that contribute to higher HF risk in PWH may lead to future preventative strategies.

Keywords: CVD, cardiovascular disease; CVRN, Cardiovascular Research Network; HF, heart failure; KP, Kaiser Permanente; PWH, people with HIV; PWoH, people without HIV; aHR, adjusted hazard ratio.

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Figures

Figure 1
Figure 1
Rates of incident heart failure among people without and with HIV, by age group. PWH, people with HIV; PWoH, people without HIV.
Figure 2
Figure 2
Rates of incident heart failure among people without and with HIV, by (A) sex and (B) race/ethnicity. API, Asian/Pacific Islander; NH, non-Hispanic; PWH, people with HIV; PWoH, people without HIV. ∗ Total number of API individuals with HIV and having 4 or more comorbidities = 39.
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References

    1. Greene M., Justice A.C., Lampiris H.W., Valcour V. Management of human immunodeficiency virus infection in advanced age. JAMA. 2013;309(13):1397–1405. - PMC - PubMed
    1. Wada N., Jacobson L.P., Cohen M., French A., Phair J., Muñoz A. Cause-specific life expectancies after 35 years of age for human immunodeficiency syndrome-infected and human immunodeficiency syndrome-negative individuals followed simultaneously in long-term cohort studies, 1984-2008. Am J Epidemiol. 2013;177(2):116–125. - PMC - PubMed
    1. Lang S., Boccara F., Mary-Krause M., Cohen A. Epidemiology of coronary heart disease in HIV-infected versus uninfected individuals in developed countries. Arch Cardiovasc Dis. 2015;108(3):206–215. - PubMed
    1. Remick J., Georgiopoulou V., Marti C., et al. Heart failure in patients with human immunodeficiency virus infection: epidemiology, pathophysiology, treatment, and future research. Circulation. 2014;129(17):1781–1789. - PMC - PubMed
    1. Kong A.M., Pozen A., Anastos K., Kelvin E.A., Nash D. Non-HIV comorbid conditions and polypharmacy among people living with HIV age 65 or older compared with HIV-negative individuals age 65 or older in the United States: a retrospective claims-based analysis. AIDS Patient Care STDS. 2019;33(3):93–103. - PMC - PubMed