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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...

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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
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author Osborn, Zachary
Joseph, Christine
Mckinnon, John
author_facet Osborn, Zachary
Joseph, Christine
Mckinnon, John
author_sort Osborn, Zachary
collection PubMed
description 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.
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spelling pubmed-62528422018-11-28 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients Osborn, Zachary Joseph, Christine Mckinnon, John Open Forum Infect Dis Abstracts 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. Oxford University Press 2018-11-26 /pmc/articles/PMC6252842/ http://dx.doi.org/10.1093/ofid/ofy210.1909 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Osborn, Zachary
Joseph, Christine
Mckinnon, John
2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title_full 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title_fullStr 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title_full_unstemmed 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title_short 2256. Racial Differences in Dyslipidemia Clinical Characteristics and Treatment Among Urban HIV Patients
title_sort 2256. racial differences in dyslipidemia clinical characteristics and treatment among urban hiv patients
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6252842/
http://dx.doi.org/10.1093/ofid/ofy210.1909
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