Paul S, Gilbert H M, Ziecheck W, Jacobs J, Sepkowitz K A
Department of Medicine, New York Hospital-Cornell University Medical College, New York 10021, USA.
AIDS. 1999 Feb 25;13(3):415-8. doi: 10.1097/00002030-199902250-00015.
Despite advances in antiretroviral treatment, a large number of HIV-infected patients still require hospitalization. This study describes the characteristics of HIV patients requiring hospitalization before and after the advent of potent antiretroviral therapies.
Information was collected on all HIV-positive patients admitted to the New York Hospital-Cornell Medical Center in New York City. Data was collected from 1 January through 30 June 1995, and during the same 6-month interval in 1997.
In each time period over 1500 outpatients were receiving treatment for HIV infection. There was a significant decrease in the incidence of admission [60.4 per 100 patient-years (PY) in 1995, 28.8 per 100 PY in 1997], and length of stay (10 versus 8 days). The median CD4 cell count of all HIV-infected patients admitted to the hospital doubled: 37 x 10(6)/l in 1995 versus 80 x 10(6)/l in 1997. However, there was no significant change in the median CD4 cell count of patients diagnosed with opportunistic infections. The incidence of the most common diagnosis (bacterial pneumonia, 8.0 per 100 PY in 1995 versus 3.6 per 100 PY in 1997) and the most common opportunistic infection (Pneumocystis carinii pneumonia 7.6 per 100 PY in 1995 versus 2.4 per 100 PY in 1997) decreased significantly.
Since the introduction of potent antiretroviral therapy, a significant decrease in the incidence of hospital admission and opportunistic infections has occurred. There has been a doubling of the median CD4 cell count of inpatients. There has been no significant change in the median CD4 cell count at which patients present with opportunistic infections.
尽管抗逆转录病毒治疗取得了进展，但仍有大量HIV感染患者需要住院治疗。本研究描述了强效抗逆转录病毒疗法出现前后需要住院治疗的HIV患者的特征。
收集了纽约市纽约医院-康奈尔医学中心所有HIV阳性住院患者的信息。数据收集时间为1995年1月1日至6月30日以及1997年相同的6个月期间。
在每个时间段，超过1500名门诊患者接受HIV感染治疗。入院发生率[1995年为每100患者年（PY）60.4例，1997年为每100 PY 28.8例]和住院时间（分别为10天和8天）显著下降。所有入院的HIV感染患者的CD4细胞计数中位数增加了一倍：1995年为37×10⁶/l，1997年为80×10⁶/l。然而，诊断为机会性感染的患者的CD4细胞计数中位数没有显著变化。最常见诊断（细菌性肺炎，1995年为每100 PY 8.0例，1997年为每100 PY 3.6例）和最常见机会性感染（卡氏肺孢子虫肺炎，1995年为每100 PY 7.6例，1997年为每100 PY 2.4例）的发生率显著下降。
自引入强效抗逆转录病毒疗法以来，入院率和机会性感染发生率显著下降。住院患者的CD4细胞计数中位数增加了一倍。出现机会性感染时患者的CD4细胞计数中位数没有显著变化。
