scholarly journals HIV infection and COVID-19 death: population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

2020 ◽  
Author(s):  
Krishnan Bhaskaran ◽  
Christopher T Rentsch ◽  
Brian MacKenna ◽  
Anna Schultz ◽  
Amir Mehrkar ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Infection ◽  
Cox Regression ◽  
Cohort Analysis ◽  
Geographical Area ◽  
Population Based ◽  
People Living With Hiv ◽  
Primary Care Data ◽  
Living With Hiv ◽  
Age And Sex

Background: It is unclear whether HIV infection is associated with risk of COVID-19 death. We aimed to investigate this in a large-scale population-based study in England. Methods: Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death registrations. People with a primary care record for HIV infection were compared to people without HIV. COVID-19 death was defined by ICD-10 codes U07.1 or U07.2 anywhere on the death certificate. Cox regression models were used to estimate the association between HIV infection and COVID-19 death, initially adjusted for age and sex, then adding adjustment for index of multiple deprivation and ethnicity, and finally for a broad range of comorbidities. Interaction terms were added to assess effect modification by age, sex, ethnicity, comorbidities and calendar time. Results: 17.3 million adults were included, of whom 27,480 (0.16%) had HIV recorded. People living with HIV were more likely to be male, of black ethnicity, and from a more deprived geographical area than the general population. There were 14,882 COVID-19 deaths during the study period, with 25 among people with HIV. People living with HIV had nearly three-fold higher risk of COVID-19 death than those without HIV after adjusting for age and sex (HR=2.90, 95% CI 1.96-4.30). The association was attenuated but risk remained substantially raised, after adjustment for deprivation and ethnicity (adjusted HR=2.52, 1.70-3.73) and further adjustment for comorbidities (HR=2.30, 1.55-3.41). There was some evidence that the association was larger among people of black ethnicity (HR = 3.80, 2.15-6.74, compared to 1.64, 0.92-2.90 in non-black individuals, p-interaction=0.045) Interpretation: HIV infection was associated with a markedly raised risk of COVID-19 death in a country with high levels of antiretroviral therapy coverage and viral suppression; the association was larger in people of black ethnicity.

scholarly journals HIV infection and COVID-19 death: a population-based cohort analysis of UK primary care data and linked national death registrations within the OpenSAFELY platform

2021 ◽  
Vol 8 (1) ◽  
pp. e24-e32
Author(s):  
Krishnan Bhaskaran ◽  
Christopher T Rentsch ◽  
Brian MacKenna ◽  
Anna Schultze ◽  
Amir Mehrkar ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Infection ◽  
Cohort Analysis ◽  
Population Based ◽  
Primary Care Data

scholarly journals Predictors of Migration in an HIV Hyper-Endemic Rural South African Community: Evidence From a Population-Based Cohort (2005-2017)

2022 ◽  
Author(s):  
Armstrong Dzomba ◽  
Hae-Young Kim ◽  
Andrew Tomita ◽  
Alain Vandormael ◽  
Kaymarlin Govender ◽  
...  
Keyword(s):  
South Africa ◽  
Cox Regression ◽  
High Mobility ◽  
Educational Status ◽  
Population Based ◽  
Treatment As Prevention ◽  
People Living With Hiv ◽  
Community Art ◽  
Socio Demographic Factors ◽  
Living With Hiv

Abstract Globally, South Africa ranks worst for people living with HIV (PLHIV) and the unique legacy of internal labour migration continues to be a major driver of the regional epidemic, interrupting treatment-as-prevention efforts. The study examined levels, trends, and predictors of migration in rural KwaZulu-Natal Province, South Africa, using population-based surveillance data from 2005 through 2017. We followed 69 604 adult participants aged 15-49 years and recorded their migration events (i.e., out-migration from the surveillance area) in 423 038 person-years over 525 397 observations. Multiple failure Cox-regression models were used to measure the risk of migration by socio-demographic factors: age, sex, educational status, marital status, HIV, and community antiretroviral therapy (ART) coverage. Overall, 69% of the population cohort experienced at least one migration event during the follow-up period. The average incidence rate of migration was 9.96 events and 13.23 events per 100 person-years in women and men, respectively. Migration rates declined from 2005 to 2008 then peaked in 2012 for both women and men. Adjusting for other covariates, the risk of migration was 3.4-times higher among young women aged 20-24 years compared to those aged ≥40 years (adjusted Hazard Ratio [aHR]=3.37, 95% Confidence Interval [CI]: 3:19-3.57), and 2.9-times higher among young men aged 20-24 years compared to those aged ≥40 years (aHR=2.86, 95% CI:2.69-3.04). There was a 9% and 27% decrease in risk of migration among both women (aHR=0.91, 95% CI: 0.83 – 0.99) and men (aHR=0.73, 95% CI 0.66 – 0.82) respectively per every 1% increase in community ART coverage. Young unmarried women including those living with HIV, migrated at a magnitude similar to that of their male counterparts, and lowered as ART coverage increased over time, reflecting the role of improved HIV services across space in reducing out-migration. A deeper understanding of the characteristics of a migrating population provides critical information towards identifying and addressing gaps in the HIV prevention and care continuum in an era of high mobility.

scholarly journals Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Jerry S. Zifodya ◽  
Meredith S. Duncan ◽  
Kaku A. So‐Armah ◽  
Engi F. Attia ◽  
Kathleen M. Akgün ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Cox Regression ◽  
Community Acquired Pneumonia ◽  
People Living With Hiv ◽  
Hiv Status ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Increased Risk ◽  
Living With Hiv

Background Hospitalization with community‐acquired pneumonia (CAP) is associated with an increased risk of cardiovascular disease (CVD) events in patients uninfected with HIV. We evaluated whether people living with HIV (PLWH) have a higher risk of CVD or mortality than individuals uninfected with HIV following hospitalization with CAP. Methods and Results We analyzed data from the Veterans Aging Cohort Study on US veterans admitted with their first episode of CAP from April 2003 through December 2014. We used Cox regression analyses to determine whether HIV status was associated with incident CVD events and mortality from date of admission through 30 days after discharge (30‐day mortality), adjusting for known CVD risk factors. We included 4384 patients (67% [n=2951] PLWH). PLWH admitted with CAP were younger, had less severe CAP, and had fewer CVD risk factors than patients with CAP who were uninfected with HIV. In multivariable‐adjusted analyses, CVD risk was similar in PLWH compared with HIV‐uninfected (hazard ratio [HR], 0.89; 95% CI, 0.70–1.12), but HIV infection was associated with higher mortality risk (HR, 1.49; 95% CI, 1.16–1.90). In models stratified by HIV status, CAP severity was significantly associated with incident CVD and 30‐day mortality in PLWH and patients uninfected with HIV. Conclusions In this study, the risk of CVD events during or after hospitalization for CAP was similar in PLWH and patients uninfected with HIV, after adjusting for known CVD risk factors and CAP severity. HIV infection, however, was associated with increased 30‐day mortality after CAP hospitalization in multivariable‐adjusted models. PLWH should be included in future studies evaluating mechanisms and prevention of CVD events after CAP.

scholarly journals The role of HIV infection in the clinical spectrum of COVID-19: a population-based cohort analysis based on US National COVID Cohort Collaborative (N3C) Enclave data

2021 ◽  
Author(s):  
Xueying Yang ◽  
Jiajia Zhang ◽  
Siyuan Guo ◽  
Bankole Olatosi ◽  
Sharon Beth Weissman ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Population Based ◽  
Elevated Risk ◽  
Clinical Severity ◽  
Severe Illness ◽  
People Living With Hiv ◽  
Electronic Health Record Data ◽  
Interaction Terms ◽  
The Us ◽  
Age And Sex

Background Evidence of whether people living with HIV (PLWH) are at elevated risk of adverse COVID-19 outcomes is limited. We aimed to investigate this association using the population-based National COVID Cohort Collaborative (N3C) data in the US. Methods The harmonized, high-granularity electronic health record data from 54 clinical sites in N3C were used for this study. Logistic and multinomial logistic regression models were employed to estimate the association between HIV infection and hospitalization, mortality, and clinical severity of COVID-19, with models being initially adjusted for age and sex, then cumulatively adjusted for race and ethnicity, smoking and obesity, and a broad range of comorbidities. Interaction terms were added to assess the modification effect by age, sex, and race. Findings Among a total of 1,436,622 adult COVID-19 cases between January 2020 and May 2021, 13,170 had HIV infection. A total of 26,130 deaths occurred, with 445 among PLWH. PLWH had a higher risk of COVID-19 death and hospitalization than non-PLWH after adjusting for age and sex. The associations were attenuated, but remained significant, after adjusting for lifestyle factors and comorbidities (COVID-19 death: [adjusted OR(AOR): 1.38; 95%CI: 1.25-1.54]; hospitalization: [AOR: 1.23; 95%CI: 1.18-1.28]). In terms of COVID-19 disease severity, PLWH were less likely to have mild/moderate illness but more likely to have a severe illness when only controlling for demographics, smoking and BMI, although the estimated risk was obviated after controlling for comorbidities. Interaction terms revealed that the elevated risk was higher among the older age group, males, and black/African American. Interpretation PLWH in the US had an increased risk of COVID-19 hospitalization and mortality comparing with non-PLWH. The adverse COVID-19 outcomes might not only be accounted for by HIV but also by other risk factors that are highly prevalent in PLWH. Funding National Center for Advancing Translational Sciences, National Institute of Allergy And Infectious Diseases, US

Population‐based outcome analysis of diffuse large B‐cell lymphoma in people living with HIV infection and competent individuals

2018 ◽  
Vol 36 (5) ◽  
pp. 757-764 ◽  
Author(s):  
Annarita Conconi ◽  
Emanuele Zucca ◽  
Gloria Margiotta‐Casaluci ◽  
Katharine Darling ◽  
Barbara Hasse ◽  
...  
Keyword(s):  
Hiv Infection ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Outcome Analysis ◽  
People Living With Hiv ◽  
Large B Cell Lymphoma ◽  
Living With Hiv ◽  
Large B Cell

scholarly journals Quality of life among people living with HIV in England and the Netherlands: a population-based study

2021 ◽  
Vol 8 ◽  
pp. 100177
Author(s):  
Stephanie Popping ◽  
Meaghan Kall ◽  
Brooke E. Nichols ◽  
Evelien Stempher ◽  
Lisbeth Versteegh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
The Netherlands ◽  
Population Based ◽  
People Living With Hiv ◽  
Population Based Study ◽  
Living With Hiv

scholarly journals Excess burden of age-associated comorbidities among people living with HIV in British Columbia, Canada: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041734
Author(s):  
Ni Gusti Ayu Nanditha ◽  
Adrianna Paiero ◽  
Hiwot M Tafessu ◽  
Martin St-Jean ◽  
Taylor McLinden ◽  
...  
Keyword(s):  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Age At Diagnosis ◽  
Secondary Outcome ◽  
People Living With Hiv ◽  
Prevalence Trends ◽  
Living With Hiv ◽  
Negative Controls ◽  
Hiv Negative

ObjectivesAs people living with HIV (PLWH) live longer, morbidity and mortality from non-AIDS comorbidities have emerged as major concerns. Our objective was to compare prevalence trends and age at diagnosis of nine chronic age-associated comorbidities between individuals living with and without HIV.Design and settingThis population-based cohort study used longitudinal cohort data from all diagnosed antiretroviral-treated PLWH and 1:4 age-sex-matched HIV-negative individuals in British Columbia, Canada.ParticipantsThe study included 8031 antiretroviral-treated PLWH and 32 124 HIV-negative controls (median age 40 years, 82% men). Eligible participants were ≥19 years old and followed for ≥1 year during 2000 to 2012.Primary and secondary outcome measuresThe presence of non-AIDS-defining cancers, diabetes, osteoarthritis, hypertension, Alzheimer’s and/or non-HIV-related dementia, cardiovascular, kidney, liver and lung diseases were identified from provincial administrative databases. Beta regression assessed annual age-sex-standardised prevalence trends and Kruskal-Wallis tests compared the age at diagnosis of comorbidities stratified by rate of healthcare encounters.ResultsAcross study period, the prevalence of all chronic age-associated comorbidities, except hypertension, were higher among PLWH compared with their community-based HIV-negative counterparts; as much as 10 times higher for liver diseases (25.3% vs 2.1%, p value<0.0001). On stratification by healthcare encounter rates, PLWH experienced most chronic age-associated significantly earlier than HIV-negative controls, as early as 21 years earlier for Alzheimer’s and/or dementia.ConclusionsPLWH experienced higher prevalence and earlier age at diagnosis of non-AIDS comorbidities than their HIV-negative controls. These results stress the need for optimised screening for comorbidities at earlier ages among PLWH, and a comprehensive HIV care model that integrates prevention and treatment of chronic age-associated conditions. Additionally, the robust methodology developed in this study, which addresses concerns on the use of administrative health data to measure prevalence and incidence, is reproducible to other settings.

Sign in / Sign up

Export Citation Format

Share Document