As HIV treatment advances and the management of persistent chronic comorbidities are prioritized, HIV-associated wasting, 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 HIV-associated wasting in the United States.

Estimated HIV-associated wasting prevalence1

Among the HIV+ Study Population (n = 42,587), 63.9% were on antiretroviral therapy (ART) (n = 27,223), 36.1% were not on ART
(n = 15,364).

Across the span of the 6-year Retrospective Medical and Pharmacy Claims analysis (2012-2018*), it was estimated that 18.3% of HIV-positive patients were identified as having HIV-associated wasting (~3.1% annually).

Prevelance during a 6 years period

Comorbidities1

The HIV-associated wasting cohort had significantly higher comorbidity burden with Charlson Comorbidity Index (CCI) mean (SD) compared to non-HIV-associated wasting: 3.6 (3.0) vs. 2.0 (2.2).

Nearly all Charlson comorbidities were more common in the HIV-associated wasting cohort compared with the non-HIV-associated wasting cohort.

Comorbidities CBVD=cerebrovascular disease; CHF=chronic heart failure; PVD=peripheral vascular disease

The HIV-associated wasting cohort also had significantly higher comorbidity burden in many other morbidities, including higher proportions of metabolic disorders such as lipodystrophy (37.5%) and dyslipidemia (48.5%). Furthermore, over 40% of the HIVAW cohort had psychiatric medical claims.

Other-Comorbidities

Correlates1

In logistic regression analysis, race and ART status were not found to be correlates of HIV-associated wasting. The strongest associations with HIV-associated wasting were with Medicaid insurance and hospitalization(s) post-HIV index.

Risk factors

Study Limitations1

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 health care claims data, it does not take into account all clinical information.

Conclusion

Conclusion1

Findings suggest HIVAW remains prevalent in people living with HIV.

ART use 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.

The people depicted on this website are not actual HIV-associated wasting patients or healthcare professionals.

Learn more about a specific treatment option for HIV-associated wasting.

PVD: Peripheral vascular disease; CHF: Chronic heart failure; CBVD: Cerebrovascular disease.
*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).2 Only those Charlson comorbidities with frequency >10% are presented in the bar chart; P-value <0.0001 for all comparisons.
§Claims for CD4 and viral load tests were a surrogate marker for being in care.

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. Roffman CE, Buchanan J, Allison GT. Charlson comorbidities index. J Physiother. 2016;62(3):171.