BMC Infectious Diseases (Apr 2021)

Causes of hospitalisation among a cohort of people with HIV from a London centre followed from 2011 to 2018

  • Sophia M. Rein,
  • Fiona C. Lampe,
  • Clinton Chaloner,
  • Adam Stafford,
  • Alison J. Rodger,
  • Margaret A. Johnson,
  • Jeffrey McDonnell,
  • Fiona Burns,
  • Sara Madge,
  • Alec Miners,
  • Lorraine Sherr,
  • Simon Collins,
  • Andrew Speakman,
  • Andrew N. Phillips,
  • Colette J. Smith

DOI
https://doi.org/10.1186/s12879-021-06082-y
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 7

Abstract

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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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