Original articleTrends in hospital admissions, re-admissions, and in-hospital mortality among HIV-infected patients between 1993 and 2013: Impact of hepatitis C co-infectionTendencia de las hospitalizaciones, reingresos y mortalidad intrahospitalaria en los pacientes infectados por VIH entre 1993-2013: impacto de la coinfección por el virus de la hepatitis C
Section snippets
Background
Since the introduction of Highly Active Antiretroviral Therapy (HAART) in 1996, the profile of people living with HIV infection (PLWH) has changed significantly; with an appreciable decline of mortality related to AIDS-defining diseases and an improvement in life expectancy. However, the incidence of other comorbidities, mainly cardiovascular diseases and non-AIDS tumors has increased, due to the longer life expectancy, aging and persistent inflammation related to the HIV-infection, even in a
Methods
The Complexo Hospitalario Universitario de A Coruña (CHUAC) is a 1422-bed, full service, 24 h ICU availability, tertiary acute university care hospital, serving in the Northwest of Spain. The influence population in 2013 was 547,776 citizens, and that year reported 40,869 admissions (21% scheduled). The HIV and Hepatitis Viral Unit offers outpatient and inpatient medical care to all PLWH in this reference area, attending more than 1400 PLWH by HIV-trained doctors. PLWH are not attended in other
Demographic characteristics and hospitalization parameters
A total of 2498 PLWH were followed during the period study, contributing to 22,901 patient-years (PY). In the study period 6917 hospital admissions were recorded, corresponding to 1937 subjects. Of them, 75.0% were male, mean age (at first hospitalization) was 36.4 ± 10.6 years, and 37.2% were HIV/HCV coinfected. Among those PLWH hospitalized, 789 (40.7%) have one admission; the median number of admission was 2 (IQR: 1–4). The hospitalization rate showed a reduction from 30.7/100 patients (CI95%:
Discussion
This study evaluates trends in hospitalizations among PLWH in a medical reference area of Northwest Spain. Overall, the hospitalizations rate showed a decline from 31/100 patients in 1993 to 20/100 patients in 2013, but remains higher than in the general population. These results are concordant with other previously published in different countries and different Health Care Systems.6, 21 The joinpoint analysis established a point of change in 1996. This behavior is related with the introduction
Conflicts of interest
All authors declare no conflicts of interest.
Acknowledgements
This work was supported in part by grants from Fondo de Investigación Sanitaria (CPII14/00014, PI10/02166, PI13/02266, CM13/00328), and Fundación Profesor Novoa Santos, A Coruña. We would like to thank Biobank of A Coruña (SERGAS) for providing us the technical, ethical and legal advice necessary for the development of our research.
References (28)
- et al.
Decline in the AIDS and death rates in the EuroSIDA study: an observational study
Lancet
(2003) - et al.
The effect of hospital experience on mortality among patients hospitalized with acquired immunodeficiency syndrome in California
Am J Med
(1999) - et al.
Deaths due to non-AIDS diseases among HIV infected patients: a 14-year study (1998–2011)
Enferm Infecc Microbiol Clin
(2016) - et al.
Presentation and outcome of hepatocellular carcinoma in HIV-infected patients: a U.S.-Canadian multicenter study
J Hepatol
(2007) - et al.
Emerging role of hepatocellular carcinoma among liver-related causes of deaths in HIV infected patients: the French national Mortalite 2005 study
J Hepatol
(2009) - et al.
Trends in mortality after diagnosis of hepatitis C virus infection: an international comparison and implications for monitoring the population impact of treatment
J Hepatol
(2015) - et al.
Causes of death among persons with AIDS in the era of highly active antirretroviral therapy: New York City
Ann Intern Med
(2006) Causes of death in HIV-1-infected patients treated with antiretroviral therapy, 1996–2006: collaborative analysis of 13 HIV cohort studies
Clin Infect Dis
(2010)- et al.
Trends on epidemiological, virological, and clinical features among newly diagnosed HIV-1 persons in Northwest Spain over the last 10 years
J Med Virol
(2015) - et al.
Thirty-day hospital readmission rate among adults living with HIV
AIDS
(2013)
Trends in reasons for hospitalization in a multisite united states cohort of persons living with HIV, 2001–2008
J Acquir Immune Defic Syndr
All-cause mortality in hospitalized HIV-infected patients at an acute tertiary care hospital with a comprehensive outpatient HIV care program in New York City in the era of highly active anti retroviral therapy (HAART)
Infection
Impact of hepatitis coinfection on hospitalization rates and causes in a multicenter cohort of persons living with HIV
J Acquir Immune Defic Syndr
Seroprevalence of HCV and HIV infections by year of birth in Spain: impact of US CDC and USPSTF recommendations for HCV and HIV testing
PLOS ONE
Cited by (0)
- ◊
These authors contributed equally in this work.