Public health weekly report · 2026
Multimorbidity Patterns and Cluster Characteristics Among People Living with HIV in the Korean HIV/AIDS Cohort, 2006-2023.
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Choi Seungmi, Park BoYoung, Ahn KyoungHwan, Hong Sunghee, Ryou Sangmi, Lee Jeong Gyu, Go MinJin, Lee Junghyun
Аннотация
OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.