Multimorbidity Patterns and Cluster Characteristics Among People Living with HIV in the Korean HIV/AIDS Cohort, 2006-2023.
Antiretroviral therapy (ART) has substantially improved survival among people living with human immunodeficiency virus (HIV), resulting in an increasing need to manage age-related chronic diseases. This study examined patterns of multimorbidity clusters and their associated factors among people living with HIV using data from the Korean HIV/AIDS Cohort.
We analyzed data from 1,606 participants enrolled in the Korean HIV/AIDS Cohort from 2006 to 2023, excluding terminated cases. Participants were categorized as having no morbidity, a single morbidity, or multimorbidity. Variable cluster analysis was performed to identify disease patterns, and multinomial logistic regression was used to identify factors associated with multimorbidity.
Multimorbidity was present in 29.8% of participants, and five disease clusters were identified. Cluster 1 included osteoporosis, cerebral hemorrhage, peripheral vascular disease, and dialysis; Cluster 2 included hepatitis B, hepatitis C, liver cirrhosis, and cancer; Cluster 3 included metabolic syndrome, dyslipidemia, and fatty liver disease; Cluster 4 included hypertension, cerebral infarction, and diabetes mellitus; and Cluster 5 included nongonococcal urethritis, gonorrhea, and condyloma. Cluster 5 was more prevalent among participants aged ≤29 years and declined with advancing age, whereas Clusters 3 and 4 increased with age. Older age at HIV diagnosis, a longer duration since diagnosis, and higher HIV RNA levels were significantly associated with multimorbidity. Initiating ART within 31-90 days after diagnosis was associated with reduced odds of multimorbidity, although baseline differences in ART timing may have contributed to this finding.
Multimorbidity patterns shifted from infection-centered to metabolic and cardio-cerebrovascular disease-centered patterns with advancing age. Integrated management strategies that account for multimorbidity cluster characteristics are essential for people living with HIV.
We analyzed data from 1,606 participants enrolled in the Korean HIV/AIDS Cohort from 2006 to 2023, excluding terminated cases. Participants were categorized as having no morbidity, a single morbidity, or multimorbidity. Variable cluster analysis was performed to identify disease patterns, and multinomial logistic regression was used to identify factors associated with multimorbidity.
Multimorbidity was present in 29.8% of participants, and five disease clusters were identified. Cluster 1 included osteoporosis, cerebral hemorrhage, peripheral vascular disease, and dialysis; Cluster 2 included hepatitis B, hepatitis C, liver cirrhosis, and cancer; Cluster 3 included metabolic syndrome, dyslipidemia, and fatty liver disease; Cluster 4 included hypertension, cerebral infarction, and diabetes mellitus; and Cluster 5 included nongonococcal urethritis, gonorrhea, and condyloma. Cluster 5 was more prevalent among participants aged ≤29 years and declined with advancing age, whereas Clusters 3 and 4 increased with age. Older age at HIV diagnosis, a longer duration since diagnosis, and higher HIV RNA levels were significantly associated with multimorbidity. Initiating ART within 31-90 days after diagnosis was associated with reduced odds of multimorbidity, although baseline differences in ART timing may have contributed to this finding.
Multimorbidity patterns shifted from infection-centered to metabolic and cardio-cerebrovascular disease-centered patterns with advancing age. Integrated management strategies that account for multimorbidity cluster characteristics are essential for people living with HIV.