Hospitalization Rates and Causes Among Persons With HIV in the United States and Canada, 2005-2015
Published by Oxford University Press for the Infectious Diseases Society of America 2020..
BACKGROUND: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015.
METHODS: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL.
RESULTS: Among 28 057 patients (125 724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/µL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories.
CONCLUSIONS: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:223 |
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| Enthalten in: |
The Journal of infectious diseases - 223(2021), 12 vom: 15. Juni, Seite 2113-2123 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Davy-Mendez, Thibaut [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 14.02.2022 Date Revised 13.04.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/infdis/jiaa661 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM316540900 |
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| 041 | |a eng | ||
| 100 | 1 | |a Davy-Mendez, Thibaut |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hospitalization Rates and Causes Among Persons With HIV in the United States and Canada, 2005-2015 |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 14.02.2022 | ||
| 500 | |a Date Revised 13.04.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by Oxford University Press for the Infectious Diseases Society of America 2020. | ||
| 520 | |a BACKGROUND: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015 | ||
| 520 | |a METHODS: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL | ||
| 520 | |a RESULTS: Among 28 057 patients (125 724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/µL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories | ||
| 520 | |a CONCLUSIONS: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, N.I.H., Intramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, P.H.S. | |
| 650 | 4 | |a HIV | |
| 650 | 4 | |a cohort studies | |
| 650 | 4 | |a hospitalization | |
| 650 | 7 | |a Anti-HIV Agents |2 NLM | |
| 700 | 1 | |a Napravnik, Sonia |e verfasserin |4 aut | |
| 700 | 1 | |a Hogan, Brenna C |e verfasserin |4 aut | |
| 700 | 1 | |a Althoff, Keri N |e verfasserin |4 aut | |
| 700 | 1 | |a Gebo, Kelly A |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Richard D |e verfasserin |4 aut | |
| 700 | 1 | |a Horberg, Michael A |e verfasserin |4 aut | |
| 700 | 1 | |a Silverberg, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Gill, M John |e verfasserin |4 aut | |
| 700 | 1 | |a Crane, Heidi M |e verfasserin |4 aut | |
| 700 | 1 | |a Marconi, Vincent C |e verfasserin |4 aut | |
| 700 | 1 | |a Bosch, Ronald J |e verfasserin |4 aut | |
| 700 | 1 | |a Colasanti, Jonathan A |e verfasserin |4 aut | |
| 700 | 1 | |a Sterling, Timothy R |e verfasserin |4 aut | |
| 700 | 1 | |a Mathews, W Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Mayor, Angel M |e verfasserin |4 aut | |
| 700 | 1 | |a Nanditha, Ni Gusti Ayu |e verfasserin |4 aut | |
| 700 | 1 | |a Buchacz, Kate |e verfasserin |4 aut | |
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| 700 | 1 | |a Rebeiro, Peter F |e verfasserin |4 aut | |
| 700 | 1 | |a Thorne, Jennifer E |e verfasserin |4 aut | |
| 700 | 1 | |a Nijhawan, Ank |e verfasserin |4 aut | |
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| 700 | 0 | |a North American AIDS Cohort Collaboration on Research and Design of IeDEA |e verfasserin |4 aut | |
| 700 | 1 | |a Benson, Constance A |e investigator |4 oth | |
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| 700 | 1 | |a Kirk, Gregory D |e investigator |4 oth | |
| 700 | 1 | |a Mayer, Kenneth H |e investigator |4 oth | |
| 700 | 1 | |a Grasso, Chris |e investigator |4 oth | |
| 700 | 1 | |a Hogg, Robert S |e investigator |4 oth | |
| 700 | 1 | |a Harrigan, P Richard |e investigator |4 oth | |
| 700 | 1 | |a Montaner, Julio S G |e investigator |4 oth | |
| 700 | 1 | |a Yip, Benita |e investigator |4 oth | |
| 700 | 1 | |a Zhu, Julia |e investigator |4 oth | |
| 700 | 1 | |a Salters, Kate |e investigator |4 oth | |
| 700 | 1 | |a Gabler, Karyn |e investigator |4 oth | |
| 700 | 1 | |a Buchacz, Kate |e investigator |4 oth | |
| 700 | 1 | |a Li, Jun |e investigator |4 oth | |
| 700 | 1 | |a Gebo, Kelly A |e investigator |4 oth | |
| 700 | 1 | |a Moore, Richard D |e investigator |4 oth | |
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| 700 | 1 | |a Carey, John T |e investigator |4 oth | |
| 700 | 1 | |a Rodriguez, Benigno |e investigator |4 oth | |
| 700 | 1 | |a Horberg, Michael A |e investigator |4 oth | |
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| 700 | 1 | |a Mayor, Angel M |e investigator |4 oth | |
| 700 | 1 | |a John Gill, M |e investigator |4 oth | |
| 700 | 1 | |a Martin, Jeffrey N |e investigator |4 oth | |
| 700 | 1 | |a Li, Jun |e investigator |4 oth | |
| 700 | 1 | |a Brooks, John T |e investigator |4 oth | |
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