Clusterization of co-morbidities and multi-morbidities among persons living with HIV: a cross-sectional study

BMC Infect Dis. 2019 Jun 25;19(1):555. doi: 10.1186/s12879-019-4184-z.


Background: Among people living with HIV (PLWH), the prevalence of non-HIV related co-morbidities is increasing. Aim of the present study is to describe co-morbidity and multi-morbidity, their clustering mode and the potential disease-disease interactions in a cohort of Italian HIV patients.

Methods: Cross-sectional analysis conducted by the Coordinamento Italiano per lo Studio di Allergia e Infezioni da HIV (CISAI) on adult subjects attending HIV-outpatient facilities. Non-HIV co-morbidities included: cardiovascular disease, diabetes mellitus, hypertension, oncologic diseases, osteoporosis, probable case of chronic obstructive pulmonary disease (COPD), hepatitis C virus (HCV) infection, psychiatric illness, kidney disease. Multi-morbidity was defined as the presence of two or more co-morbidities.

Results: One thousand and eighty-seven patients were enrolled in the study (mean age 47.9 ± 10.8). One hundred-ninety patients (17.5%) had no co-morbidity, whereas 285 (26.2%) had one condition and 612 (56.3%) were multi-morbid. The most recurrent associations were: 1) dyslipidemia + hypertension (237, 21.8%); 2) dyslipidemia + COPD (188, 17.3%); 3) COPD + HCV-Ab+ (141, 12.9%). Multi-morbidity was associated with older age, higher body mass index, current and former smoking, CDC stage C and longer ART duration.

Conclusions: More than 50% of PLHW were multi-morbid and about 30% had three or more concurrent comorbidities. The identification of common patterns of comorbidities address the combined risks of multiple drug and disease-disease interactions.

Keywords: Clusterization; Co-morbidity; Disease-disease interactions; HIV; Multi-morbidity.

MeSH terms

  • AIDS-Related Opportunistic Infections / epidemiology
  • Adult
  • Aged
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / epidemiology
  • Cluster Analysis
  • Cohort Studies
  • Comorbidity
  • Cross-Sectional Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • HIV
  • HIV Infections / complications
  • HIV Infections / epidemiology*
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Italy / epidemiology
  • Male
  • Middle Aged
  • Multimorbidity*
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / epidemiology