AEGiS-14IAC: Hospitalary Admissions in the HAART era: A Prospective Study.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Hospitalary Admissions in the HAART era: A Prospective Study.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10674)

Iribarren JA, Arrizabalaga J, Camino X, Jimeno B, Rodriguez F, von Wichmann MA, Landa MA, Izko A, Pascual L
Chief of Infectious Diseases Unit, San Sebastian, Spain

OBJECTIVES: To know why patients need hospitalary admissions (HA) in the HAART era. To describe and compare the characteristics between patients with less than 50 copies/ml (PU) and patients (P) admitted with detectable VL (PD).

METHODS: Prospective cohort study of all P with HIV infection needing HA to the Infectious Diseases Unit between 01/01/00 and 30/06/00.

RESULTS: 99 P (69 male, 30 female) generated 140 HA. 70 exIVDU, 14 active IVDU, 12 hetero, 3 others. 60 had AIDS before admission, 17 developed AIDS on admission. 50 P were in HAART. Only 11/49 P not in HAART had more than 350 CD4 (the majority of other P did not keep appointments). 28 P (28%) had UVL, and generated 34 HA. Mean of CD4: 393 in PU, 255 in PD (p<0,05). All the PU were in HAART, vs 22/71 (30%) of PD (p<0,05). The diagnosis on discharge in PU were: 22 (64%) non opportunistic (NNO) infection (14 respiratory); 7 other NNO diseases; only 4 opportunistic conditions. The probability of discharge with diagnosis of an opportunistic condition in PU was lower (11%) than in PD (29/106; 27%; p<0,05). 12/99 P died during admission; 9/12 from an AIDS condition. Only 1 had UVL (p=ns). Of the 39 P without AIDS before HA (12 PU; 27 PD), 17 were diagnosed as AIDS during HA (2/12 -16%-PU; 15/27 PD -55%-; p <0,05). It was less probable (p <0,05) that P had UVL if they were active IVDU (7% vs 31% other practice risks); had a psychiatric condition (23 vs 45% in no psychiatric) or bad social situation (6% vs 32%). The probability of short-time (3 m) readmission, was lesser in PU (22,7%) than in PD (44%).

CONCLUSION: 28% of the P that are admitted in a ward in the HAART era have VL <50 copies. These P have less severe diseases (mainly respiratory bacterial infections) than other P, and a better CD4 count, with few opportunistic conditions and less readmissions. Some groups of P, such as active IVDU, psychiatric disease and bad social situation, have less probability of having UVL.

Keywords: AEGIS, Antiretroviral Therapy, Highly Active, Prospective Studies, CD4 Lymphocyte Count, HIV Infections, Acquired Immunodeficiency Syndrome, Cohort Studies, Female, Male, Human

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C10674