Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice
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RESEARCH
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Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice Elisabetta Garagiola1*, Emanuela Foglia1, Lucrezia Ferrario1, Paola Meraviglia2, Alessandro Tebini3, Barbara Menzaghi3, Chiara Atzori2, Giuliano Rizzardini2,4, Teresa Bini5, Antonella D’Arminio Monforte5 and Davide Croce1,6
Abstract Background: Since HIV+ treatment has become more effective, the average age of people living with HIV (PLWHIV) has increased, and consequently the incidence of developing comorbidities, making the clinical and economic management of HIV+ patients more complex. Limited literature exists regarding the management of comorbidities costs. This study is aimed at defining and comparing the total annual costs of comorbidities, in an Italian cohort of HIV and HIV/HCV patients, from the National Healthcare Service perspective. The authors hypothesised that there are higher costs, for patients with multiple comorbidities, and a greater consumption of resources for HIV/HCV coinfected patients versus HIV mono-infected patients. Methods: An observational retrospective multi-centre health-economics study, enrolling HIV+ and HIV/HCV consecutive patients with at least one comorbidity, was conducted. The consecutive cases, provided by three Italian infectious diseases centres, were related to the year 2016. The enrolled patients were on a stable antiviral therapy for at least six months. Demographic and clinical information was recorded. Costs related to HIV and HCV therapies, other treatments, medical examinations, hospitalizations and outpatient visits were evaluated. Data from monoinfected and co-infected groups of patients were compared, and the statistical analysis was performed by t-tests, chi-square and ANOVA. A sub-analysis excluding HCV therapy costs, was also conducted. The hierarchical sequential linear regression model was used to explore the determinants of costs, considering the investigated comorbidities. All analyses were conducted with a significant level of 0.05. (Continued on next page)
* Correspondence: [email protected] 1 Centre for Research on Health Economics, Social and Health Care Management, LIUC–Università Cattaneo, Castellanza, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permiss
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