Evidence map›Paper›PMID 34462891›Full record

ArticleCanadian journal of public health = Revue canadienne de sante publique2021

Disparities in multimorbidity and mortality among people living with and without HIV across British Columbia's health regions: a population-based cohort study.

Ni Gusti Ayu Nanditha, Grace Zheng, Hiwot M Tafessu, Taylor McLinden, Andreea Bratu, Jacek Kopec, Robert S Hogg, Julio S G Montaner, Viviane D Lima

Abstract read
In one paragraph

Article in Canadian journal of public health = Revue canadienne de sante publique, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Observational
  4. Article
  5. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ni Gusti Ayu Nanditha *British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Grace Zheng *Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Hiwot M TafessuBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Taylor McLindenBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Andreea BratuBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Jacek KopecSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
Robert S HoggBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Julio S G MontanerBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Viviane D LimaBritish Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. vlima@bccfe.ca.ORCID http://orcid.org/0000-0003-4943-091X

Funding

Seek and Treat for Optimal Prevention of HIV & AIDS (STOP HIV/AIDS) in BCR01DA036307 · NIDA · UNIVERSITY OF BRITISH COLUMBIA · PI MONTANER, JULIO SERGIO GONZALEZ · 2013 to 2017
$3.0M
Canadian HIV Trials Network, Canadian Institutes of Health Research CTN248CIHR 130419CIHR PJT-148595NIDA NIH HHS R01 DA036307
6 · The paper itself

Abstract

objectivesLonger survival has increased the likelihood of antiretroviral-treated people living with HIV (PLWH) developing age-associated comorbidities. We compared the burden of multimorbidity and all-cause mortality across HIV status in British Columbia (BC), and assessed the longitudinal effect of multimorbidity on all-cause mortality among PLWH.

methodsAntiretroviral-treated PLWH aged ≥19 years and 1:4 age-sex-matched HIV-negative individuals from a population-based cohort were followed for ≥1 year during 2001-2012. Diagnoses of seven age-associated comorbidities were identified from provincial administrative databases and grouped into 0, 1, 2, and ≥3 comorbidities. Multimorbidity prevalence and age-standardized mortality rates (ASMRs) in both populations were stratified by BC's health regions. Marginal structural models were used to estimate the effect of multimorbidity on mortality among PLWH, adjusted for time-varying confounders affected by prior multimorbidity.

resultsAmong 8031 PLWH and 32,124 HIV-negative individuals, 25% versus 11% developed multimorbidity, and 23.53 deaths/1000 person-years (95% confidence interval [95% CI]: 22.02-25.13) versus 3.04 (2.81-3.29) were observed, respectively. PLWH in Northern region had the highest ASMR, but those in South Vancouver Island experienced the greatest difference in mortality compared with HIV-negative individuals. Among PLWH, compared with those with zero comorbidities, adjusted hazard ratios for those with 1, 2, and ≥3 comorbidities were 3.36 (95% CI: 2.86-3.95), 6.92 (5.75-8.33), and 12.87 (10.45-15.85), respectively.

conclusionPLWH across BC's health regions experience excess multimorbidity and associated mortality. We highlight health disparities which are key when planning the distribution of healthcare resources across BC, and provide evidence for improved HIV care models integrating prevention and management of chronic diseases.

Indexed as

HIV InfectionsMultimorbidityAnti-Retroviral AgentsBritish ColumbiaCohort StudiesHumansAnti-Retroviral AgentsBritish ColumbiaHealth regionsHIVMortalityMultimorbidity

Identifiers

PMID34462891
PMCPMC8651938

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.