Web of Science: 2 cites, Scopus: 3 cites, Google Scholar: cites
Antiretroviral Therapy (ART) Use, Human Immunodeficiency Virus (HIV)-1 RNA Suppression, and Medical Causes of Hospitalization Among HIV-Infected Intravenous Drug Users in the Late ART Era
Vallecillo Sánchez, Gabriel (Hospital del Mar)
Mojal, Sergio (Departament d'Estadística i Investigació Operativa. Parc de Recerca Biomédica de Barcelona)
Torrens, Marta (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Muga, Roberto (Hospital del Mar)

Data: 2014
Resum: Background: Antiretroviral therapy (ART) has reduced the rates and changed the causes of hospital admission. However, human immunodeficiency virus-positive intravenous drug users (HIV-IDU) continue to have increased hospitalizations and discharge diagnosis are less defined in the late ART era. Our aim was to examine ART use, HIV-1 RNA suppression, and hospital discharge diagnoses among HIV-IDU admitted to an urban hospital. Methods: A retrospective analysis was made of HIV-IDU admitted for medical causes for the first time (2006-2010). Surgical, obstetric, or mental (except HIV-associated neurocognitive disorder) diagnoses were excluded. Clinical characteristics, number of admissions, and primary discharge diagnoses were determined for each patient. Results: Three hundred and seventy-five admissions were recorded among 197 hospitalized HIV-IDU. Lifetime prevalence of ART use was 83. 2% (164 of 197) and the rate of HIV-1 RNA <50 copies/mL was 38. 1% (75 of 197). Primary discharge diagnosis groups were as follows:acterial infections (59. 2%), chronic end-organ damage (16. 8%), complications derived from injected drug use (16. 8%), malignancies (9. 1%), and opportunistic infections (6. 6%). Chronic end-organ damage was diagnosed more frequently in patients with HIV-1 RNA <50 copies/mL (36% vs 4. 9%; P < . 000), and complications derived from injected drug use (23. 8% vs 5. 3%; P < . 0008) and acquired immune deficiency syndrome (AIDS) opportunistic infections (19. 8% vs 1. 3% P < . 019) were usually diagnosed in patients with HIV-1 RNA detectable viral load. Conclusions: Human immunodeficiency virus-positive intravenous drug users are admitted to hospitals mainly for non-AIDS-related illnesses; however, sustained HIV-1 RNA viral load suppression is poor and determines hospital discharge diagnoses. Providers need to be aware of the management of HIV-related comorbidities and reinforce strategies to improve ART retention in this population.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades. Creative Commons
Llengua: Anglès
Document: article ; recerca ; publishedVersion
Matèria: Antiretroviral therapy ; HIV-infected drug users ; Hospitalization
Publicat a: Open Forum Infectious Diseases, Vol. 1 (june 2014) , ISSN 2328-8957

DOI: 10.1093/ofid/ofu010
PMID: 25734084


6 p, 106.8 KB

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