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AIDS Care. 2018 Dec;30(12):1551-1559. doi: 10.1080/09540121.2018.1499855. Epub 2018 Jul 27.

Reconciling the evaluation of co-morbidities among HIV care patients in two large data systems: the Medical Monitoring Project and CFAR Network of Integrated Clinical Systems.

Author information

1
a HIV Epidemiology and Surveillance Section , Public Health- Seattle & King County , Seattle , WA , USA.
2
b Department of Epidemiology , University Washington , Seattle , WA , USA.
3
c Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA.
4
d Department of Biostatistics , University Washington , Seattle , WA , USA.
5
e Department of Medicine , University of Washington , Seattle , WA , USA.
6
f School of Medicine , University of Alabama , Birmingham , AL , USA.
7
g School of Medicine , University of California San Francisco , San Francisco , CA , USA.
8
h Department of Medicine , University of California San Diego , San Diego , CA , USA.
9
i Department of Medicine , Johns Hopkins University , Baltimore , MD , USA.

Abstract

The estimated burden of chronic disease among people living with HIV (PLWH) varies considerably by data source, due to differences in case definitions, analytic approaches, and underlying patient populations. We evaluated the burden of diabetes (DM) and chronic kidney disease (CKD) in two large data systems that are commonly queried to evaluate health issues affecting HIV care patients: the Medical Monitoring Project (MMP), a nationally representative sample, and the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS), a clinical cohort. In order to reconcile these two data sources, we addressed issues common to observational data, including selection bias, missing data, and development of case definitions. The overall adjusted estimated prevalence of DM and CKD in MMP was 12.7% and 7.6%, respectively, and the overall prevalence of DM and CKD in CNICS was 9.9% and 8.3%, respectively; prevalence estimates increased with age in both data sources. After reconciling the approach to analyzing MMP and CNICS data, sub-group specific prevalence estimates of DM and CKD was generally similar in both data sources. Both data sources suggest a considerable burden of disease among older adults in HIV care. MMP and CNICS can provide reliable data to monitor HIV co-morbidities in the US.

KEYWORDS:

HIV/AIDS; chronic kidney disease; co-morbidity; diabetes; observational study

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