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Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY

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Abstract

Aging, HIV infection, and antiretroviral therapy have been associated with increasing rates of chronic comorbidities in patients with HIV. Urban minority populations in particular are affected by both the HIV/AIDS and chronic disease epidemics. Our objectives were to estimate the prevalence of and risk factors for hypertension, dyslipidemia, and diabetes among HIV-infected adults in the Bronx and describe comorbidity-related treatment outcomes. This was a cross-sectional study of 854 HIV-positive adults receiving care at 11 clinics which provide HIV primary care services; clinics were affiliated with a large urban academic medical center. Data on blood pressure (BP), cholesterol, and glycemic control were collected through standardized chart review of outpatient medical records. We found prevalence rates of 26%, 48%, and 13% for hypertension, dyslipidemia, and diabetes, respectively. Older age, obesity, family history, and current protease inhibitor use were consistently associated with comorbidity. Diabetes treatment goals were achieved less often than BP and lipid goals, and concurrent diabetes was a significant predictor for BP and lipid control. In conclusion, major cardiovascular-related comorbidities are prevalent among HIV-positive adults in the Bronx, especially older and obese individuals. Differences exist in comorbidity-related treatment outcomes, especially for patients with concurrent diabetes. Because cardiovascular risk is modifiable, effective treatment of related comorbidities may improve morbidity and mortality in HIV-infected patients.

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Acknowledgments

The authors gratefully acknowledge the support and helpful contributions of the Research Division in the Department of Family and Social Medicine at Montefiore Medical Center, the Albert Einstein College of Medicine’s Clinical Research Training Program, and the MMG/Bronx Community Health Network’s CICERO program.

Financial Support

This work was funded through the New York State Department of Health’s Empire Clinical Research Investigator Program. In addition, it was made possible by CTSA Grants UL1 RR025750, KL2 RR025749, and TL1 RR025748 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessary represent the official view of the NCRR or NIH.

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Correspondence to Carolyn Chu.

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Previous presentations

A portion of the data was presented in poster format at the 2009 AHRQ Practice-Based Research Network Conference in Bethesda, Maryland (June 24–26, 2009) and at the 2010 International AIDS Conference in Vienna, Austria (July 18–23, 2010).

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Chu, C., Umanski, G., Blank, A. et al. Comorbidity-Related Treatment Outcomes among HIV-Infected Adults in the Bronx, NY. J Urban Health 88, 507–516 (2011). https://doi.org/10.1007/s11524-010-9540-7

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