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[undiagnosed comorbidities] Systematic screening for age-related comorbidities: health care optimization among individuals living with HIV in the out-patient clinic in Copenhagen, Denmark
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EACS 2025 Oct 15-18 Paris
A.K.H. Roed1, S. Singh1, A.-M. Lebech1, O. Kirk1, S.D. Nielsen1, Viro-immunology Research Unit, Department of Infectious Diseases 8632, Rigshospitalet, University of Copenhagen
1Copenhagen University Hospital, Department of infectious diseases, Copenhagen, Denmark
Abstract
Purpose: As the population of people living with HIV (PWH) ages, the prevalence of non-AIDS age-related comorbidities has become increasingly significant. As a result, current HIV management guidelines increasingly emphasize the importance of risk assessment and prevention of these conditions, however, the adoption of these screening approaches is often hindered by organizational barriers and resource limitations. We determined the prevalence of known age-related comorbidities and assessed the risk of unrecognized cases through a comprehensive screening procedure in a clinical out-patient setting.
Method: This cross-sectional assessment conducted among PWH ≥60 years, evaluated risk of cardiovascular disease (CVD), fracture risk, lung disease and vaccination status for key preventative infections. Screening assessments were conducted to identify individuals at risk, warranting further diagnostic evaluation. Patients were offered the opportunity to participate following their routine HIV-care visit and non-attenders were contacted by phone.
Results: 387 out of 523 (72.7%) eligible individuals participated in the screening. 224 (57.9%) had history of ³1 comorbidity. Results show that 81 (35.7%) participants exhibited undiagnosed hypertension. 87 (22.5%) participants had history of CVD. Of those with no history, 202 (67.6%) and 57 (19%) were in the high risk and very-high risk SCORE2 category, respectively. 62 (16%) had history of chronic pulmonary disease. Among participants with no history, 27 (10.3%) had symptoms of chronic lung disease and 36 (13.8%) had air flow limitation according to screening spirometry. 52 (13.4%) of participants had a history of osteoporosis. Among those with no history 17 (5.1%) had a 10-year major osteoporotic fracture risk ³20%. Of these, 9 (52.9%) had undergone DXA-scan (Dual-energy X-ray absorptiometry) within the last 5 years. 204 (52.7%) of participants lacked one or more recommended vaccinations.
Conclusions: These findings demonstrate that a structured screening protocol in routine HIV-care may enhance the identification of comorbid conditions, allowing for timely interventions and improved health outcomes.
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