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. 2025 Nov 6;81(4):806-814.
doi: 10.1093/cid/ciaf167.

Changes in the Prevalence of Non-AIDS Conditions Among Hospitalized Persons With HIV in the United States and Canada, 2008-2018

Thibaut Davy-Mendez  1   2 , Sonia Napravnik  1   2 , Brenna C Hogan  3 , Joseph J Eron  1   2 , Kelly A Gebo  3   4 , Keri N Althoff  3   4 , Richard D Moore  3   4 , Michael J Silverberg  5 , Michael A Horberg  6 , M John Gill  7 , Jonathan A Colasanti  8 , Ank Nijhawan  9 , Maile Y Karris  10 , Marina B Klein  11 , Raynell Lang  12 , Catherine R Lesko  3 , George A Yendewa  13 , Gregory D Kirk  3   4 , Kathleen A McGinnis  14 , Stephen A Berry  3   4 ; North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of the International Epidemiology Databases to Evaluate AIDS (IeDEA)
Collaborators, Affiliations

Changes in the Prevalence of Non-AIDS Conditions Among Hospitalized Persons With HIV in the United States and Canada, 2008-2018

Thibaut Davy-Mendez et al. Clin Infect Dis. .

Abstract

Background: Hospitalization causes among persons with HIV (PWH) have shifted to non-AIDS conditions, but the complete disease profile of hospitalized PWH has not been well described. To inform hospitalization and readmission prevention efforts, we examined non-AIDS disease prevalence among PWH hospitalized in 4 US cohorts and 1 Canadian cohort.

Methods: Among PWH with ≥1 hospitalization from 2008 to 2018, we used log-binomial regression with generalized estimating equations to estimate trends in the annual prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease (CKD) stage ≥3, and multimorbidity (≥2 and ≥3 conditions), defined using longitudinal diagnosis, medication, and laboratory data.

Results: We examined 6781 hospitalized PWH who were 75% cisgender men, 40% White, and 38% Black. From 2008 to 2018, the proportion of PWH in care who had ≥1 hospitalization decreased from 9.6% to 6.3%. Age- and cohort-adjusted prevalence increased for hyperlipidemia (relative change per year: 3.6% [95% CI: 2.5%-4.7%]), diabetes mellitus (2.8% [1.3%-4.4%]), CKD (3.3% [1.7%-4.9%]), ≥2 conditions (1.3% [0.6%-2.0%]), and ≥3 conditions (3.0% [1.7%-4.3%]), decreased for HCV infection (-2.0% [-3.0%, -0.9%]), and remained stable for HBV infection (1.6% [-1.1%, 4.3%]) and hypertension (0.4% [-0.2%, 1.1%]).

Conclusions: Hospitalized PWH had an increasing burden of several non-AIDS conditions and multimorbidity not accounted for by aging alone. Further work is needed to understand these conditions' role in hospitalization risk among PWH. Our findings reinforce that hospital discharge planning in PWH should include efforts to ensure chronic conditions are adequately managed.

Keywords: HIV; aging; comorbidity; hyperlipidemia; hypertension.

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Conflict of interest statement

Potential conflicts of interest. J. A. C. reports consulting fees from Prime Education and Integritas Communications. J. J. E. reports grants or contracts from Gilead Sciences and ViiV Healthcare; consulting fees from Merck, ViiV Healthcare, Gilead Sciences, and AbbVie; and participation in a Data and Safety Monitoring Board (DSMB) or advisory board for Merck and TIAMED. K. A. G. reports royalties or licenses from Up-to-Date; consulting fees from Spark HealthCare, Premier HealthCare, MedEd Learning, and Harrison Consulting and MedEd Learning; and participation in a DSMB or advisory board for Shionogi and Pfizer. M. J. G. reports honoraria as an ad hoc member of HIV national advisory boards to Merck, ViiV Healthcare, and Gilead Sciences. M. Y. K. reports grants or contracts from Gilead Sciences and ViiV Healthcare, membership on the San Diego County Standards and Strategies Committee, and board membership of Being Alive. M. B. K. reports grants or contracts from AbbVie, Gilead Sciences, and ViiV Healthcare, and consulting fees from AbbVie, Gilead Sciences, and ViiV Healthcare. A. N. reports grants or contracts from Gilead Sciences and participation in a DSMB for the National Institutes of Health. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
A–F, Unadjusted annual prevalence (%) of health conditions among hospitalized persons with HIV (solid lines): NA-ACCORD, 2008–2018. For reference, prevalences among all 28 381 persons with HIV in care (11 000–17 000 each year) are also shown (dashed lines). Abbreviations: HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; NA-ACCORD, North American AIDS Cohort Collaboration on Research and Design.
Figure 2.
Figure 2.
A–J, Unadjusted prevalence of non-AIDS health conditions stratified by the 10 most frequent categories of primary hospital discharge diagnosis: NA-ACCORD, 2008–2018. Displayed from left to right within each panel are the prevalence of HBV infection (red), HCV infection (blue), treated hypertension (green), treated hyperlipidemia (purple), diabetes mellitus (orange), chronic kidney disease stage ≥3 (brown), ≥2 conditions (pink), and ≥3 conditions (gray). Abbreviations: HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; NA-ACCORD, North American AIDS Cohort Collaboration on Research and Design.
See this image and copyright information in PMC

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