JMIR Publications

ABSTRACT

Background:

Over 60% of people aging with HIV are observed to have multiple comorbidities; attributed to a variety of factors (e.g., biological, environmental), with sex differences observed. However, understanding these differences and their contribution to medical resource utilization remains challenging.

Objective:

For further insight, we analyzed HIV patient data matched by sex.

Methods:

ICD9/10 diagnostic codes that comprise the Electronic Health Records from a clinical data warehouse of male (N=229) and female (N=229) patients were categorized by individual characteristics, chronic and mental health conditions, treatment, high risk behaviors and infections, and used as predictors of medical resource utilization represented by Charlson Comorbidity scores.

Results:

Significant contributors to high Charlson scores in males were age (β =2.37; 1.45, 3.29), longer hospital stay (β=0.046; 0.009, 0.083), malnutrition (β=2.96; 1.72, 4.20) kidney failure (β=2.23; 0.934, 3.52); chemotherapy (β= 3.58; 2.16, 5.002), prior tobacco use (β= 1.40; 0.200, 2.61) and Hepatitis C (β= 1.49; 0.181, 2.79). For females, age (β=1.37; 0.361, 2.38), longer hospital stay (β=0.042; 0.005, 0.078), heart failure (β= 2.41; 0.833, 3.98); chemotherapy (β= 3.48; 1.626, 5.33) and substance abuse (β= 1.94; 0.180, 3.702).

Conclusions:

Our findings identified sex-based differences in medical resource utilization. Increased prevalence of comorbidities in aging people with HIV has the potential to overburden global health systems; the development of narrower HIV sex-based phenotypes with greater clinical validity will support intervention efficacy and successful aging.