Early post-diagnosis changes in non-communicable disease burden in people with HIV: a nationwide cohort study in Taiwan.

OBJECTIVES

To characterize dynamic changes in non-communicable disease (NCD) burden during the first two years after HIV diagnosis and to assess whether these changes differed across transmission groups.

METHODS

This population-based cohort study linked Taiwan's national HIV registry with health insurance claims for 18640 adults diagnosed with HIV (2005-2013). NCD burden was classified as 0, 1, or ≥2 categories at baseline, Year 1, and Year 2. Transitions were analyzed using multinomial logistic regression.

RESULTS

Recorded NCD burden showed dynamic and frequently bidirectional transitions despite stable population-level multimorbidity. Over 40% of individuals with baseline multimorbidity transitioned to a lower recorded burden category by Year 1. At diagnosis, multimorbidity prevalence was 6.2%, ranging from 4.2% in men who have sex with men (MSM) to 13.1% in heterosexual women. After adjustment, age and late presentation were more consistently associated with bidirectional changes in recorded NCD burden than transmission group. Recorded metabolic disease prevalence increased in MSM, whereas recorded neuropsychiatric diagnoses declined in people who inject drugs.

CONCLUSION

Claims-recorded NCD burden after HIV diagnosis changed dynamically rather than uniformly progressing. The early post-diagnosis period thus represents a critical window for clinical reassessment, supporting repeated comorbidity assessment and transmission group-informed screening.