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Publication Detail
Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018
  • Publication Type:
    Journal article
  • Publication Sub Type:
    Article
  • Authors:
    Rein SM, Lampe FC, Chaloner C, Stafford A, Rodger AJ, Johnson MA, McDonnell J, Burns F, Madge S, Miners A, Sherr L, Collins S, Speakman A, Phillips AN, Smith CJ
  • Publisher:
    BioMed Central
  • Publication date:
    29/04/2021
  • Pagination:
    395
  • Journal:
    BMC Infectious Diseases
  • Volume:
    21
  • Issue:
    1
  • Status:
    Published
  • Country:
    England
  • Print ISSN:
    1471-2334
  • PII:
    10.1186/s12879-021-06082-y
  • Language:
    eng
  • Keywords:
    AIDS, Causes, Diagnoses, HIV, Hospitalization, Morbidity
Abstract
BACKGROUND: We describe the spectrum of ICD-10 classified causes for hospitalisations occurring between 2011 and 2018 in a cohort of people living with HIV (PLHIV). METHODS: This sub-study includes 798 PLHIV participating in the Antiretroviral, Sexual Transmission Risk and Attitudes (ASTRA) questionnaire study who were recruited from a large London centre. A medical record review identified the occurrence and causes of hospitalisation from the date of questionnaire completion (February-December 2011) until 1 June 2018. Up to five causes were classified by an HIV clinician using the ICD-10 system. RESULTS: There were 274 hospitalisations in 153 people (rate = 5.8/100 person-years; 95% CI: 5.1, 6.5). Causes were wide-ranging; the most common were circulatory (16.8%), digestive (13.1%), respiratory (11.7%), infectious diseases (11.0%), injury/poisoning (10.6%), genitourinary diseases (9.9%) and neoplasms (9.1%). A tenth (27/274) of hospitalisations were related to at least one AIDS-defining illness. Median duration of hospitalisation was 5 days (IQR 2-9). At the time of hospitalisation, median CD4 count was high (510 cells/μl; IQR: 315-739), while median CD4 nadir was relatively low (113 cells/μl; IQR: 40-239). At admission, half of individuals (51%) had a previous AIDS-defining illness and 21% had viral load > 50 copies/ml. Individuals admitted for infectious diseases were particularly likely to have unfavourable HIV-related clinical characteristics (low CD4, viral non-suppression, not on antiretroviral therapy (ART), previous AIDS). CONCLUSIONS: In the modern combination antiretroviral therapy era, the spectrum of causes of hospitalisation in PLHIV in the UK is wide-ranging, highlighting the importance of holistic care for PLHIV, including prevention, early detection and treatment of comorbidities.
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