Cumulative Viral Load and Risk of Diabetes and Hypertension in People with HIV: An Analysis of Electronic Health Records

• Activity Number: 320 - Electronic Health Records, Causal Inference and Miscellaneous
• Type: Contributed
• Date/Time: Wednesday, August 11, 2021 : 3:30 PM to 5:20 PM
• Sponsor: Section on Statistics in Epidemiology
• Author(s): Adovich Rivera* and Lauren Beach and Juned Siddique and Donald Lloyd-Jones and Matthew Feinstein
• Companies: Northwestern University and Northwestern University and Northwestern University and Northwestern University and Northwestern University
• Keywords: HIV; diabetes; hypertension; electronic health records; joint model

Abstract

People with the human immunodeficiency virus (PWH) have been found to have higher prevalence of diabetes mellitus (DM) and hypertension (HTN); two diseases that increase cardiovascular risk. While likely multifactorial, an unresolved aspect is the role of cumulative viral loads on DM and HTN risk. Reducing the viral load should reduce the occurrence of DM and HTN through lower inflammation and metabolic derangements. However, viral load reduction can only be achieved with prolonged use of antiretroviral therapy, some of which have been associated with increased risk for DM and HTN. It is unclear what is the net result of the two processes. To answer this question, we analyzed electronic records of PWH from an academic center in Chicago, 2004-2020. We used joint longitudinal-survival models to model DM or HTN risk and viral load over time using the JMBayes package in R. We found that the cumulative viral load was not associated with risk of HTN (n=2,132, HR=1.09, 95%CI: 0.96-1.22) nor of DM (n=2,282, HR=1.15, 95%CI: 0.997-1.32). High DM and HTN prevalence in PWH under treatment are likely due to behavioral and social factors rather than from virus-related mechanisms.