General medical and psychiatric comorbidity among HIV-infected veterans in the post-HAART era
General medical and psychiatric comorbidity among HIV-infected veterans in the post-HAART era
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DOI：
10.1016/s0895-4356(01)00443-7
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发表时间：
2001-12-01
影响因子：
7.2
通讯作者：
Weissman, S
中科院分区：
文献类型：
--
作者：
Kilbourne, AM;Justice, AC;Weissman, S
我们根据最近一项接受治疗的HIV感染退伍军人的多地点队列研究：HIV/AlDS退伍军人3站点研究（VACS 3），按年龄检查了HIV、一般医疗和精神病合并症的患病率。VACS 3包括1999年6月至2000年7月期间入组的881例成人HIV感染患者。提供者报告了他们患者的CDC定义的HIV合并症、一般医学合并症（基于杜克和查尔森合并症量表）和精神病合并症。参与者的平均年龄为49岁，54%为非洲裔美国人。最常见的HIV合并症是口腔念珠菌病（21%）、周围神经病变（16%）和带状疱疹（16%）。最常见的一般内科合并症包括化学性肝炎（53%）、高血压（24%）和高脂血症（17%）。患者经历的HIV和一般医学合并症的平均数量分别为1.1和1.4（P <0.001）。年龄较大（大于或等于50岁）的HIV感染者比年龄< 50岁的HIV感染者经历更多的一般医学合并症（分别为1.7和1.2，P <0.001）。不同年龄组的平均HIV合并症数量无显著差异。根据患者报告，46%的患者有明显的抑郁症状（10项CES-D评分大于或等于10），21%的患者报告有饮酒风险（AUDIT评分大于或等于8）。提供者报告32%的患者患有焦虑症，4%患有躁狂症，4%患有精神分裂症，11%患有认知障碍/痴呆症。一般的医疗和精神疾病的合并症构成了更高的疾病负担，艾滋病毒感染的退伍军人比艾滋病毒合并症。无论这些合并症是由于抗逆转录病毒药物毒性或年龄或生活方式相关的条件，这些“非HIV”合并症的大量患病率表明，一般的医疗和精神管理的HIV感染患者的重要作用。(C)2001 Elsevier Science Inc. All rights reserved.
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/AlDS 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 (greater than or equal to 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 (greater than or equal to 10 on 10-item CES-D) and 21% reported at-risk drinking (greater than or equal to8 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. (C) 2001 Elsevier Science Inc. All rights reserved.