OBJECTIVES: The success of antiretroviral therapy (ART) has led to human immunodeficiency virus (HIV) being considered a treatable chronic condition. However, the need for life-long therapy in HIV-positive patients presents a number of challenges including long-term renal, cardiovascular (CV) and bone toxicities. The study objective was to evaluate the impact of HIV on health care resource utilization and costs among patients with comorbidities, using the Quebec public drug plan database (RAMQ) METHODS: HIV-positive patients who had received ART for at least 6 months from January 2006 to June 2012 were selected and categorized in 4 groups: 1) patients with CV, bone or renal comorbidity, 2) patients with CV comorbidity, 3) patients with bone comorbidity and 4) patients with renal comorbidity. Three controls of HIV-negative patients with the same comorbidities were matched for age groups and gender to each HIV-positive case. Comorbidity date was defined as the date of the first medication, diagnosis or medical procedure related to comorbidities. Health care resource utilization and costs were measured in the 2 years following comorbidity date.

RESULTS: A total of 1,983 HIV-positive patients with comorbidity were identified, in which 1,498 had CV comorbidity, 915 had bone comorbidity and 191 had renal comorbidity. The mean total health care cost per year was higher in HIV-positive than in HIV-negative patients with comorbidity (CAN$22,037;SD=16,935 vs. CAN$3,620;SD=7,418, p<0.01). For patients with CV and bone comorbidity, similar results were obtained. For patients with renal comorbidity, the mean total health care cost per year was higher for HIV-positive than for HIV-negative patients (CAN$29,759;SD=24,827 vs. CAN$9,193;SD=17,659, p<0.01) and costs in both groups were higher than groups with other comorbidities.

CONCLUSIONS: HIV-positive patients with renal, bone or CV comorbidities had increased health care costs when compared to HIV-negative patients with the same comorbidities. Renal comorbidity had the highest health care costs.