As HIV treatment advances and the management of persistent chronic comorbidities is prioritized, HIVAW, as a disease state, should not be overlooked.
A Retrospective Medical and Pharmacy Claims Study (2012-2018*) across payer markets was conducted to understand the ongoing prevalence of HIVAW in the US. The following results were published in 2022.1
Comorbidity burden was measured using the Charlson Comorbidities Index (CC1)‡ mean (SD)
CBVD=cerebrovascular disease; PVD=peripheral vascular disease.
In logistic regression analysis, ART status was not correlated with HIVAW. This observation confirms previous evidence that HIVAW continues to occur in PWH who receive ART.
The strongest associations with HIVAW were having Medicaid insurance and hospitalization(s) post-HIV index.
Claims data are not specifically collected for research purposes, and diagnostic and drug-use information are not always validated. As such, there can be missing information that limits the inferences that can be made from the data.
As an analysis of administrative healthcare claims data, it does not take into account all clinical information.
Findings suggest HIVAW remains prevalent in people living with HIV.
ART was not found to be associated with HIVAW. HIVAW was highest among those with Medicaid coverage or any hospitalization(s).
Further research is needed to better understand additional factors associated with and contributing to HIVAW.
A first-of-its-kind study evaluating the association of HIVAW/low weight and all-cause mortality in recent years (2016-2021) was conducted using electronic healthcare records (EHR).2
The study cohort was part of the Observational Pharmaco-Epidemiological Research & Analysis (OPERA®) database, which contained prospectively captured, HIPAA-compliant, routine clinical data.
HIPAA=Health Insurance Portability and Accountability Act.
5%
of PWH who experienced HIVAW died
2%
who had not experienced HIVAW
The model did not consider other comorbidities (eg, cardiovascular disease) or their treatments (including HIVAW/low-weight treatment).
The model did not include behaviors that may contribute to the risk of comorbidities and mortality, because these data are not consistently available in the EHR.
Findings suggest HIVAW remains a challenge for some people with HIV despite viral control.
Timely identification and treatment of HIVAW is important to help restore health and potentially reduce mortality risk.
Future studies should further explore the complex relationships among HIVAW/low weight, ART use, virologic changes, and mortality.
*2012-2013 includes Medicaid only.
†On ART is defined as >1 pharmacy claim of any ART 12 months post-HIV index.
‡The Charlson Comorbidities Index is a validated health status assessment based on a summary score of 17 comorbidities (rated from 1 to 6 for mortality risk and disease severity).3 Only those Charlson comorbidities with frequency >10% are presented in the bar chart; p value <0.0001 for all comparisons.
§When adjusted for time-dependent covariates, including viral load measurements and VACS index scores over follow-up (n=1193 of 62,067).
The people depicted on this website are not actual healthcare providers or patients with HIV-associated wasting.
References: 1. Siddiqui J, Samuel SK, Hayward B, et al. HIV-associated wasting prevalence in the era of modern antiretroviral therapy. AIDS. 2022;36(1):127-135. 2. Wohlfeiler MB, Weber RP, Brunet L, et al. Incident HIV-associted wasting/low weight is associated with nearly doubled mortality risk in the modern ART era. AIDS Res Hum Retroviruses. 2024; doi.org/10.1089/AID.2023.0113
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