New thesis sheds light on the complex link between co-morbidities and HIV
Isabela Killander Möller from the subunit of Clinical Infectious Diseases (CID) at the Center for Infectious Medicine (CIM), Department of Medicine, Huddinge (MedH), will defend her thesis entitled "Health Outcomes and Social Determinants in People Living with HIV in Sweden: Insights from the COVID-19 Era and Beyond" on 2 October. Her supervisor is Christina Carlander.
What is the main focus of your thesis?
My thesis assessed health outcomes and comorbidities in people with HIV in Sweden, with a focus on COVID-19 and type 2 diabetes mellitus. Using comprehensive Swedish national register data, we studied the risk of severe COVID-19, COVID-19 vaccination uptake, and the risk of serious complications after a diabetes diagnosis, comparing people with and without HIV.
Which are the most important results?
By including the entire or Swedish adult population or a large sample from it, while also accounting for socioeconomic factors such as income, education, and country of birth, we found that people living with HIV did not have a significantly increased risk of severe COVID-19. We also found that COVID-19 vaccination uptake was lower among people with HIV, but that this was largely explained by a higher proportion of this group being born outside Sweden, which itself was associated with lower vaccination uptake. Finally, we showed that people with HIV had an increased risk of serious kidney complications following a diabetes diagnosis, compared to people without HIV, a finding that warrants clinical attention and further research.
Taken together, the thesis highlights that the relationship between comorbidities and HIV is complex and likely influenced by factors beyond the HIV infection itself, socioeconomic status and demographics also play an important role.
How can this new knowledge contribute to the improvement of people’s health?
Understanding that the risk of comorbidities in people with HIV is not only driven by HIV infection itself or antiviral treatment, but also by social factors allows for improved targeted interventions. For example, vaccination campaigns can be designed to reach those at highest risk of not being vaccinated, in this case, predominantly people born outside Sweden, rather than targeting the HIV population. The findings may also guide clinicians to monitor kidney function more closely in patients living with both HIV and diabetes, as the research continues to understand the association.
Beyond HIV, the results also shed light on the impact that lower socioeconomic status and being born abroad can have on health – something that has previously been documented, but remains an important public health challenge.
What are your future ambitions?
In the short term, I plan to complete the research projects I initiated during my PhD and finish my combined clinical-research training, currently at Botvids Vårdcentral. My long-term goal is to work as a physician at an infectious disease clinic, eventually becoming a specialist, while continuing to combine clinical practice with research in infectious disease and epidemiology.
Public defence
Friday 2 October, 09:00, 9Q Månen, floor 9, ANA Futura, Alfred Nobels allé 8, Flemingsberg