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Comorbidity and comedication burden in people living with HIV in the United States: updated findings from a contemporary cohort (2020-2024)
Objective
To describe comorbidity and comedication burden among people living with HHIV(PLWH) compared with matched people without HIV and evaluate 5-year trends among PLWH from 2020-2024.
Methods
This retrospective study used administrative claims data (01/01/2016-01/31/2025) from Optum’s de-identified Clinformatics Data Mart Database. The PLWH cohort included adults with ≥1 medical or pharmacy claim for an antiretroviral therapy (ART) agent in 2024 or, for those not treated with ART, an HIV diagnosis code alone (index date: earliest ART or HIV claim). People without HIV were matched 2:1 to PLWH based on age group, sex, race/ethnicity, region, and insurance type. Baseline characteristics, comorbidity burden, and comedication burden were compared between matched cohorts.
Results
26,078 PLWH and 52,156 matched people without HIV were included (mean age: 59 years). Compared with people without HIV, PLWH had greater baseline Quan-Charlson comorbidity index scores (mean [SD]: 1.24 [1.86] vs. 0.99 [1.85]; p < 0.001) and greater numbers of comorbid conditions (3.70 [3.63] vs. 3.14 [3.79]; p < 0.001) and non-ART comedications (9.2 [7.58] vs 7.1 [7.48]; p < 0.001). Multimorbidity (≥2 comorbidities: 66.4% vs. 53.6%) and polypharmacy (≥5 non-ART drugs: 68.5% vs. 52.7%) were significantly more prevalent in PLWH (both p < 0.001). The most prevalent comorbidities were hypertension (46.9% vs. 41.2%; p < 0.001), hyperlipidemia (46.0% vs. 34.4%; p < 0.001), and type 2 diabetes (21.8% vs. 22.1%, p = 0.393).
Conclusions
PLWH have greater comorbidity and comedication burdens than people without HIV. The findings suggest clinicians should consider these factors when choosing ART to minimize drug interactions and adverse events, thereby improving the long-term health of PLWH.
Authors
S P Fleming, S Kamat, G Prajapati, K M Lee, V Chirikov, T LeMasters, P N Kumar
Journal
Current Medical Research and Opinion
Therapeutic Area
Infectious diseases and vaccines
Center of Excellence
Real-world Evidence & Data Analytics
Year
2026
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