4th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 22-25 September 2002, San Diego, CA, USA

AGE AND GENDER DIFFERENCES IN TREATMENT OF ANTIRETROVIRAL TREATMENT-ASSOCIATED DYSLIPIDEMIA AMONG HIV/AIDS PATIENTS

Antiviral Therapy 2002; 7:L30 (abstract 43)

UH Iloeje¹, H Kawabata² and Y Wu^1
1Pharmaceutical Research Institute, Bristol-Myers Squibb Company, Wallingford, Conn., USA; ²Pharmaceutical Research Institute, Bristol-Myers Squibb Company, Princeton, NJ, USA

OBJECTIVES: The treatment patterns of HIV-associated dyslipidemia is not well described. Early development of dyslipidemia may be associated with higher long-term risks of cardiovascular disease. Because highly active antiretroviral therapy (HAART) may obviate cardioprotective factors among HIV-infected females as well as increase risk of CVD in males, we sought to evaluate the age and gender differences in dyslipidemia therapy in HIV/AIDS patients on antiretroviral treatment (ART).

METHODS:: We studied 33,597 adult HIV patients diagnosed by ICD-9 code on ART for ≥30 days in the California Medicaid administrative claims database from January 1996 to June 2000. ART and lipid lowering therapies were identified by NDC codes. A logistic regression model was derived to predict the odds ratio (OR) of dyslipidemia therapy adjusted for protease inhibitor (PI) exposure, age and gender.

RESULTS: Of the 33,597 subjects, 26% were women and 74% were men. Age was categorized (18-34: 38%; 35-54: 56%; over 55: 6%). Half (16,811) were prescribed a PI-containing regimen. Of the 33,597 patients, 2546 (7.6 %) had any claim for lipid drug therapy during the study period. The adjusted OR for receiving lipid therapy were 0.88 (95% CI 0.70-1.12) for men: 3.98 (3.46-4.59) age category and 1.46 (1.14-1.85) for PI exposure. Among patients on PI therapy, men were significantly more likely to receive lipid therapy (OR 2.91, 95% CI 2.34-3.62), and older men were less likely to receive lipid therapy than younger men (OR 0.68, 95% CI 0.57-0.81).

CONCLUSION: In our study, male HIV patients on PI therapy were about three times more likely to be on dyslipidemia therapy than female patients on PI therapy. Younger male patients on PI therapy are 32% more likely to be on dyslipidemia therapy than older male patients on PI therapy. These results show a bias towards treating younger male patients. These results may reflect a concern by physicians over the long-term effects of untreated dyslipidemia in these patients.

Presenting author: UH Iloeje

2002-09-22
43

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