Publications

Publications

Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

Comorbidity indices in people with HIV and considerations for coronavirus disease 2019 outcomes.

Authors

Winston A, De Francesco D, Post F, Boffito M, Vera J, Williams I, Anderson J, Mallon PWG, Sabin CA.

Lay summary

COVID-19 outcomes have been shown to be worse in people with pre-existing clinical conditions.  People with HIV are thought to have an increased risk of some of these conditions.  Therefore, we wished to describe these co-morbidities using tools that have been recommended for COVID-19 monitoring.  WE measured three standard indices of comorbidities – the Elixhauser Comorbidity Index (ECI), the Charlson Comorbidity Index and the Comorbidity Burden Index – and compared each of these between older people with HIV and HIV-negative controls in the study.  While all three indices were significantly higher in people with HIV than in controls, the size of the differences in the scores between the two groups were relatively small.  In particular, the differences that we saw were driven by more individuals with HIV being within the higher end of the range.

Research theme

The predictors of pain extent in people living with HIV

The predictors of pain extent in people living with HIV

Authors

Sabin CA, Harding R, Bagkeris E, Geressu A, Nkhoma K, Post FA, Sachikonye M, Boffito M, Anderson J, Mallon PWG, Williams I, Vera J, Johnson MA, Babalis D, Winston A.

Lay summary

We described the number of people with HIV who reported widespread pain, and investigated whether this was more common in people who were being treated for HIV or who had a low CD4 count.  POPPY participants were asked to shade on a picture the regions of their body where they were experiencing pain.  Using this information, we separated the group into those who had no pain, those who had pain in only a limited number of body sites, and those with widespread pain.  Overall, pain was commonly reported by all study participants in the legs, back and shoulders.  Almost 20% of people with HIV over the age of 50 years were found to have widespread pain – this compared to just over 10% of younger people with HIV and under 10% of the older HIV-negative controls in the study.  Widespread pain was more common in those with a lower educational level and those who had been exposed to a larger number antiretroviral drugs for a longer period.  Our findings emphasise the importance of monitoring and treating pain in people with HIV.

Research theme

Respiratory symptoms and chronic bronchitis in people with and without HIV infection

Respiratory symptoms and chronic bronchitis in people with and without HIV infection

Authors

Sabin CA, Kunisaki KM, Bagkeris E, Post FA, Sachikonye M, Boffito M, Anderson J, Mallon PWG, Williams I, Vera JH, Johnson M, Babalis D, Winston A.

Lay summary

Many people with HIV report chest problems (including bronchitis). We measured chest problems in the POPPY study using a shortened version of the St. George's Respiratory Questionnaire for chronic obstructive pulmonary disease (COPD).  Our aim was to investigate whether chest problems were more common in people with HIV and, if so, whether these seemed to be related to measures of HIV disease stage, including the CD4 count. The study included 619 participants.  Respiratory Symptom scores were higher in people with HIV compared to the HIV-negative controls in the study.  Overall, just over 1 in 10 of the study participants met our criteria for chronic bronchitis, but this was more common in the people with HIV in the study.  Smoking was the strongest risk factor for chest problems, but even after taking this into account, people with HIV were over four times as likely to show signs of chronic bronchitis than those without HIV.  Despite this, we did not find any strong associations with the person’s CD4 count, HIV viral load or whether they had previously been diagnosed with AIDS.  Overall, people with chest problems reported poorer quality of life and had greater depressive symptom scores.

Research theme

Associations between widespread pain and sleep quality in people with HIV

Associations between widespread pain and sleep quality in people with HIV

Authors

Sabin CA, Harding R, Doyle N, Redline S, De Francesco D, Mallon PWG, Post FA, Boffito M, Sachikonye M, Geressu A, Winston A, Kunisaki KM.

Lay summary

We know that pain and poor sleep quality tend to go hand-in-hand, but the association between the two has not previously been investigated in people with HIV.  We asked POPPY participants to describe the parts of their body where they were currently feeling pain by shading the areas on a picture of the body.  Using this information, we grouped people into those with no pain, those with pain at only a few body sites, and those with widespread pain. In the subgroup of people who were also in the POPPY-Sleep study, we then measured sleep patterns three years later and described the association between the two.  Of the 414 participants in this sub-study, 18% reported widespread.  Although there were few clear associations between the extent of pain and some of the more objective assessments of sleep quality, people with widespread and regional pain consistently reported poorer sleep quality on all self-reported measures than those with no pain. These associations did not change greatly when we took account of other factors that are related to sleep and/or pain.

Research theme