title: Moving from viral suppression to comprehensive patient-centered care: the high prevalence of comorbid conditions and health risk factors in HIV-1-infected patients in Australia.
abstract: HIV clinicians today need to move from focusing on viral suppression to a chronic disease model in which comorbid conditions and risk factors are comprehensively identified and addressed to reduce rates of serious non-AIDS-related morbidity and mortality. This study aimed to determine the prevalence of comorbid conditions in an Australian HIV-positive population. Of 180 patients included, there was a median CD4 count of 0.520 cells/mm(3). The majority (88%) of patients were currently receiving highly active antiretroviral therapy (HAART). There were high rates of failure to attend clinical appointments (30%), current smoking (42%), hypertension (16%), and dyslipidemia (17%). Significant rates of dipstick-positive proteinuria (16%) and elevated blood glucose (15%) were recorded. Risk factors were commonly not addressed by the treating clinician. There is an urgent need to systematize detection and management of high-prevalence comorbid conditions to prevent premature mortality associated with serious non-AIDS events.
authors.affiliation: 1Sunshine Coast Clinical School, The University of Queensland, Queensland, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Broom
authors.forename: David
authors.initials: D
authors.lastname: Sowden
authors.forename: Merran
authors.initials: M
authors.lastname: Williams
authors.forename: Kuong
authors.initials: K
authors.lastname: Taing
authors.forename: Karen
authors.initials: K
authors.lastname: Morwood
authors.forename: Karen
authors.initials: K
authors.lastname: McGill
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D003191:Comprehensive Health Care; D003863:Depression / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D050171:Dyslipidemias / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology; D015497:HIV-1; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology; D055985:Latent Tuberculosis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology; D010349:Patient Compliance; D015995:Prevalence; D011507:Proteinuria / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology; D012907:Smoking / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology