Lipid Screening in HIV-Infected Veterans

P. Todd Korthuis, Steven M. Asch, Henry D. Anaya, Hal Morgenstern, Matthew Bidwell Goetz, Elizabeth M. Yano, Lisa V. Rubenstein, Martin L. Lee, Samuel A. Bozzette

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background: Lipid screening is recommended for patients taking protease inhibitors (PIs). Methods: We examined data from the Veterans Administration Immunology Case Registry to assess lipid screening among HIV-infected veterans who received PIs for at least 6 consecutive months during 1999 and 2001. We estimated crude and adjusted associations between lipid screening and patient characteristics (age, gender, HIV exposure, and race/ethnicity), comorbidities (AIDS, cardiovascular disease, diabetes, hypertension, smoking, and hyperlipidemia), and facility characteristics (urban location, case management, guidelines, and quality improvement programs). Results: Among 4065 patients on PIs, clinicians screened 2395 (59%) for lipids within 6 months of initiating treatment. Adjusting for patient characteristics, comorbidities, facility traits, and clustering, lipid screening was more common among patients who were cared for in urban areas (relative risk [RR] = 1.3, confidence limits: 1.0-1.5), diabetic (RR = 1.2, confidence limits: 1.1-1.3), or previously hyperlipidemic (RR = 1.4, confidence limits: 1.3-1.5) and less common among patients with a history of intravenous drug use (IVDU) (RR = 0.90, confidence limits: 0.79-1.0) or unknown HIV risk (RR = 0.85, confidence limits: 0.75-0.95). Conclusions: Six in 10 patients taking PIs receive lipid screening within 6 months of PI use. Systemic interventions to improve overall HIV quality of care should also address lipid screening, particularly among patients with unknown or IVDU HIV risk and those cared for in nonurban areas.

Original languageEnglish (US)
Pages (from-to)253-260
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume35
Issue number3
DOIs
StatePublished - Mar 1 2004

Keywords

  • AIDS
  • HIV
  • Hyperlipidemia
  • Protease inhibitors
  • Quality of health care

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Korthuis, P. T., Asch, S. M., Anaya, H. D., Morgenstern, H., Goetz, M. B., Yano, E. M., Rubenstein, L. V., Lee, M. L., & Bozzette, S. A. (2004). Lipid Screening in HIV-Infected Veterans. Journal of Acquired Immune Deficiency Syndromes, 35(3), 253-260. https://doi.org/10.1097/00126334-200403010-00005