Cargando…

2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients

BACKGROUND: Racial and ethnic minorities comprise an increasing proportion of the US population, and are disproportionately affected by HIV. Dyslipidemia is a key comorbidity in HIV due to high prevalence and demonstrated racial disparities in testing and treatment among non-HIV patients. Previous a...

Descripción completa

Detalles Bibliográficos
Autores principales: Osborn, Zachary, Joseph, Christine, Mckinnon, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252842/
http://dx.doi.org/10.1093/ofid/ofy210.1909
Descripción
Sumario:BACKGROUND: Racial and ethnic minorities comprise an increasing proportion of the US population, and are disproportionately affected by HIV. Dyslipidemia is a key comorbidity in HIV due to high prevalence and demonstrated racial disparities in testing and treatment among non-HIV patients. Previous analysis has showed that HIV-positive African American (AA) patients were less likely to have had a lipid profile done and less likely to have been diagnosed with dyslipidemia than other racial groups. METHODS: Electronic medical records (EMR) identified 1,457 HIV patients from the HIV clinic at Henry Ford Hospital, Detroit, Michigan from March 2013 to November 2015. Race/ethnicity and gender were identified by self-report and then a retrospective EMR review of patients tested for, and documented ICD-9 codes for dyslipidemia was done. Descriptive analyses and group comparisons were performed between AA and other racial/ethnic groups. RESULTS: 1,220 HIV patients had lipid levels tested with 25.7% having dyslipidemia after HIV diagnosis. Among those, it was found that lipid abnormalities varied by race; on average, Hispanics, had lower total cholesterol (P = 0.040), AA patients had lower triglycerides (P < 0.001), and White patients had higher triglycerides (P > 0.001). HDL levels were higher in AA patients and lowest in White patients (P < 0.001), while Hispanics had lower LDL values (P-value 0.009). There was no statistically significant (P = 0.519) difference between the lipid lowering drug (LLD) group prescribed by race, and the type of dyslipidemia was the primary predictor of LLD provided to the patients (P < 0.001). Patients prescribed fibrates were statistically more likely to have met their ATP III treatment goals at 1 year as compared with statins, regardless of race (P = 0.005). The odds of meeting treatment goals were 54% (OR 0.46, CI 0.26–0.71) less among AA patients regardless of medication. CONCLUSION: Dyslipidemia is prevalent in our HIV population. Racial differences in testing, lipid abnormalities and treatment outcomes among these vulnerable HIV minorities necessitate further investigation to close the gaps in care and improve our management of dyslipidemia for our HIV patients. DISCLOSURES: All authors: No reported disclosures.