General medical and psychiatric comorbidity among HIV-infected veterans in the post-HAART era.

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  • Author(s): Kilbourne AM;Kilbourne AM; Justice AC; Rabeneck L; Rodriguez-Barradas M; Weissman S
  • Source:
    Journal of clinical epidemiology [J Clin Epidemiol] 2001 Dec; Vol. 54 Suppl 1, pp. S22-8.
  • Publication Type:
    Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • Language:
    English
  • Additional Information
    • Corporate Authors:
      VACS 3 Project Team
    • Source:
      Publisher: Elsevier Country of Publication: United States NLM ID: 8801383 Publication Model: Print Cited Medium: Print ISSN: 0895-4356 (Print) Linking ISSN: 08954356 NLM ISO Abbreviation: J Clin Epidemiol Subsets: MEDLINE
    • Publication Information:
      Publication: New York : Elsevier
      Original Publication: Oxford ; New York : Pergamon Press, c1988-
    • Subject Terms:
      Veterans*; AIDS-Related Opportunistic Infections/*epidemiology ; HIV Infections/*epidemiology ; Mental Disorders/*epidemiology; Age Factors ; Chronic Disease ; Comorbidity ; Female ; Humans ; Longitudinal Studies ; Male ; Prevalence ; Risk Factors ; Statistics, Nonparametric ; United States/epidemiology
    • Abstract:
      We examined the prevalence of HIV, general medical, and psychiatric comorbidities by age based on a recent multisite cohort of HIV infected veterans receiving care: the Veterans with HIV/AIDS 3 Site Study (VACS 3). VACS 3 includes 881 adult patients with HIV infection enrolled between June 1999 and July 2000. Providers reported their patients' CDC-defined HIV comorbidities, general medical comorbidities (based on Duke and Charlson comorbidity scales), and psychiatric comorbidity. Mean age of participants was 49 years and 54% were African-American. The most common HIV comorbidities were oral candidiasis (21%), peripheral neuropathy (16%), and herpes zoster (16%). The most common general medical comorbidities included chemical hepatitis (53%), hypertension (24%), and hyperlipidemia (17%). The mean number of HIV and general medical comorbidities experienced by patients were respectively 1.1 and 1.4 (P < .001). Older (> or = 50 years) HIV-infected patients experienced a greater number of general medical comorbidities than those < 50 years (respectively 1.7 versus 1.2, P < .001). There was no significant difference in mean HIV comorbidity number by age. Based on patient report, 46% had significant depressive symptoms (> or = 10 on 10-item CES-D) and 21% reported at-risk drinking (> or = 8 on AUDIT). Providers reported 32% of patients had anxiety, 4% mania, 4% schizophrenia, and 11% cognitive impairment/dementia. General medical and psychiatric comorbidities constituted a higher disease burden for HIV-infected veterans than HIV comorbidities. Whether these comorbidities are due to antiretroviral drug toxicity or are age or lifestyle-associated conditions, the substantial prevalence of these "non-HIV" comorbidities suggest an important role for general medical and psychiatric management of HIV-infected patients.
    • Grant Information:
      K23 AG 00826-03 United States AG NIA NIH HHS
    • Publication Date:
      Date Created: 20011226 Date Completed: 20020129 Latest Revision: 20220408
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/s0895-4356(01)00443-7
    • Accession Number:
      11750206