Background. As a result of advances in antiretroviral therapy, non-HIV related conditions including cardiovascular diseases are becoming the leading causes of morbidity and mortality in patients with HIV. Thus, appropriate lipid screening is increasingly important in the outpatient care of HIV patients. We compared rates of lipid screening of HIV patients compared with non-HIV controls in an urban tertiary care center.
Methods. We performed a case-control study of all HIV-positive patients > 20 years (cases) who had at least 2 visits between January 1-December 31, 2011 with Infectious Diseases (ID) physicians. Controls were age-and gender-matched patients seen by Internal Medicine (IM) physicians at least twice during the same period. We collected the following information: demographics, underlying conditions (including hypertension, diabetes mellitus, tobacco use and family history of cardiovascular disease), whether screening was performed and if it was compliant with USPSTF lipid profile screening guidelines. For the cases, we also collected data on whether they had a primary care provider (PCP). Statistical analysis was done by chi-squared analysis using SPSS vs 21.0. A p < 0.05 is considered significant.
Results. A total of 153 cases and 152 controls were included in the study. The groups were evenly matched in terms of age (46.6 years in both groups) and gender (69.9% male in cases, 71.1% in controls). Cases had a higher frequency of tobacco use (50.9% vs 25.6%, p < 0.0001), hypertension defined by increased blood pressure (31.4% vs 19.1%, p < 0.013) and non-coronary atherosclerosis (7.2% vs 2%, p < 0.03). There was an overall lower rate of compliance with lipid screening among cases (60.1% vs 78.9%, p < 0.0001). There was no difference in compliance with lipid screening based on whether or not cases had a PCP (61.9% PCP vs 57.1% no PCP, p = 0.586).
Conclusion. In our institution, HIV-positive patients had lower rates of compliance with standard lipid screening guidelines compared with age- and gender-matched controls. The level of compliance was not affected by the presence of a PCP. Further education to all providers is needed to ensure appropriate lipid screening in this population.
Disclosures. All authors: No reported disclosures.