INTRODUCTION: Hospitalization rates for comorbid conditions among persons living with HIV in the current highly active antiretroviral therapy era are unknown. METHODS: Hospitalization data from 2001 to 2008 were obtained on 11,645 adults receiving longitudinal HIV care at 4 geographically diverse US HIV clinics within the HIV Research Network. Modified clinical classification software from the Agency for Healthcare Research and Quality assigned primary ICD-9 codes into diagnostic categories. Analysis was performed with repeated measures negative binomial regression. RESULTS: During 2001 to 2008, the rate of AIDS-defining illness (ADI) hospitalizations declined from 6.7 to 2.7 per 100 person-years, incidence rate ratio per year, 0.89 (0.87, 0.91). Among the other diagnostic categories with average rates >2 per 100 person-years, cardiovascular hospitalizations increased over time [1.07 (1.03, 1.11)], whereas non-AIDS-defining infection [0.98 (0.96, 1.00)], psychiatric [0.96 (0.93, 1.00)], and gastrointestinal/liver [0.96 (0.92, 1.00)] were slightly decreasing or stable. Although less frequent overall, renal and pulmonary admissions also increased over time in univariate and multivariate analyses. Of all diagnostic categories, ADI admissions had the longest mean length of stay, 10.5 days. DISCUSSION: ADI hospitalizations have continued to decline in recent years but are still relatively frequent and potentially costly given long lengths of stay. Increases or stability in the rates of chronic end-organ disease admissions imply a need for broader medical knowledge among individual clinicians and/or teams who care for persons living with HIV and a need for long-term access to medications for these conditions.
INTRODUCTION: Hospitalization rates for comorbid conditions among persons living with HIV in the current highly active antiretroviral therapy era are unknown. METHODS: Hospitalization data from 2001 to 2008 were obtained on 11,645 adults receiving longitudinal HIV care at 4 geographically diverse US HIV clinics within the HIV Research Network. Modified clinical classification software from the Agency for Healthcare Research and Quality assigned primary ICD-9 codes into diagnostic categories. Analysis was performed with repeated measures negative binomial regression. RESULTS: During 2001 to 2008, the rate of AIDS-defining illness (ADI) hospitalizations declined from 6.7 to 2.7 per 100 person-years, incidence rate ratio per year, 0.89 (0.87, 0.91). Among the other diagnostic categories with average rates >2 per 100 person-years, cardiovascular hospitalizations increased over time [1.07 (1.03, 1.11)], whereas non-AIDS-defining infection [0.98 (0.96, 1.00)], psychiatric [0.96 (0.93, 1.00)], and gastrointestinal/liver [0.96 (0.92, 1.00)] were slightly decreasing or stable. Although less frequent overall, renal and pulmonary admissions also increased over time in univariate and multivariate analyses. Of all diagnostic categories, ADI admissions had the longest mean length of stay, 10.5 days. DISCUSSION: ADI hospitalizations have continued to decline in recent years but are still relatively frequent and potentially costly given long lengths of stay. Increases or stability in the rates of chronic end-organ disease admissions imply a need for broader medical knowledge among individual clinicians and/or teams who care for persons living with HIV and a need for long-term access to medications for these conditions.
Authors: Marian E Betz; Kelly A Gebo; Ed Barber; Peter Sklar; John A Fleishman; Erin D Reilly; W Christopher Mathews Journal: Med Care Date: 2005-09 Impact factor: 2.983
Authors: Ira B Wilson; Bruce E Landon; Lisa R Hirschhorn; Keith McInnes; Lin Ding; Peter V Marsden; Paul D Cleary Journal: Ann Intern Med Date: 2005-11-15 Impact factor: 25.391
Authors: David B Hanna; Wendy S Post; Jennifer A Deal; Howard N Hodis; Lisa P Jacobson; Wendy J Mack; Kathryn Anastos; Stephen J Gange; Alan L Landay; Jason M Lazar; Frank J Palella; Phyllis C Tien; Mallory D Witt; Xiaonan Xue; Mary A Young; Robert C Kaplan; Lawrence A Kingsley Journal: Clin Infect Dis Date: 2015-04-22 Impact factor: 9.079
Authors: Elizabeth Holmes; David Thompson; Deborah Michell; Janessa M Smith; Meredith Ilana Zoltick; Kelly A Gebo; Richard D Moore; Lois Eldred; Andrea Ciaranello; Stephen A Berry Journal: J Assoc Nurses AIDS Care Date: 2019 Mar-Apr Impact factor: 1.354
Authors: Engi F Attia; Kathleen A McGinnis; Laura C Feemster; Kathleen M Akgün; Adeel A Butt; Christopher J Graber; Michael J Fine; Matthew B Goetz; Maria C Rodriguez-Barradas; Margaret A Pisani; Hilary A Tindle; Sheldon T Brown; Guy W Soo Hoo; David Rimland; Cynthia L Gibert; Laurence Huang; Matthew S Freiberg; Catherine L Hough; Kristina Crothers Journal: J Acquir Immune Defic Syndr Date: 2015-11-01 Impact factor: 3.731
Authors: Anna L Hotton; Kathleen M Weber; Ronald C Hershow; Kathryn Anastos; Peter Bacchetti; Elizabeth T Golub; Deborah Gustafson; Alexandra M Levine; Mary Young; Mardge H Cohen Journal: J Acquir Immune Defic Syndr Date: 2017-06-01 Impact factor: 3.731
Authors: Henry Masur; John T Brooks; Constance A Benson; King K Holmes; Alice K Pau; Jonathan E Kaplan Journal: Clin Infect Dis Date: 2014-02-27 Impact factor: 9.079
Authors: Stephen A Berry; John A Fleishman; Baligh R Yehia; P Todd Korthuis; Allison L Agwu; Richard D Moore; Kelly A Gebo Journal: AIDS Date: 2013-08-24 Impact factor: 4.177
Authors: David B Hanna; Chitra Ramaswamy; Robert C Kaplan; Jorge R Kizer; Kathryn Anastos; Demetre Daskalakis; Regina Zimmerman; Sarah L Braunstein Journal: Clin Infect Dis Date: 2016-07-20 Impact factor: 9.079