Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK2100 Copenhagen Ø, Denmark.
AIDS. 2010 Jan 28;24(3):457-61. doi: 10.1097/QAD.0b013e328332828d.
HAART has changed morbidity and mortality in the HIV-infected population dramatically. We aimed to estimate the use of healthcare facilities in HIV-infected patients after the introduction of HAART.
This is a prospective nationwide cohort study.
We identified all Danish HIV patients and a cohort of population controls matched on sex and date of birth. The study period was 1995-2007. We calculated inpatient admission rates and outpatient visit rates stratified by medical speciality and International Classification of Diseases-10 diagnose categories. Relative risks were computed.
Four thousand, seven hundred and sixty HIV-infected patients and 23 800 population controls were identified. Overall inpatient admission rates [95% confidence interval (CI)] for HIV-infected patients decreased from 90 (88-93) to 57 (56-58)/100 person-years in the study period. The risk ratio (95% CI) fell from 6.2 (6.0-6.5) to 3.1 (3.1-3.2) predominantly due to reduced inpatient admission rates to departments of infectious diseases. The overall outpatient visit rates (95% CI) for the HIV-infected patients increased from 744 (737-751) to 877 (872-882)/100 person-years, mainly due to visits at departments other than infectious diseases. A marked increase in outpatient visit rates (95% CI) in the background population decreased the risk ratio from 16.5 (16.2-16.8) to 7.1 (7.0-7.2). We observed a decreased relative risk of inpatient admissions and outpatient visits due to cancers and a small increase in relative risk due to cardiovascular disease.
After the introduction of HAART, the inpatient treatment of HIV-infected patients has decreased, especially at departments of infectious disease. In contrast, this population's use of outpatient facilities has increased in noninfectious disease specialities.
高效抗逆转录病毒治疗（HAART）显著改变了 HIV 感染者的发病率和死亡率。本研究旨在评估 HAART 引入后 HIV 感染者对医疗设施的使用情况。
这是一项前瞻性全国性队列研究。
我们确定了所有丹麦 HIV 患者和一组按性别和出生日期匹配的人群对照。研究期间为 1995 年至 2007 年。我们按医疗专业和国际疾病分类-10 诊断类别对住院和门诊就诊率进行分层计算。计算了相对风险。
共确定了 4760 名 HIV 感染者和 23800 名人群对照。HIV 感染者的总住院率[95%置信区间（CI）]从研究期间的 90（88-93）降至 57（56-58）/100 人年。风险比（95%CI）从 6.2（6.0-6.5）降至 3.1（3.1-3.2），主要是由于传染病科住院率下降。HIV 感染者的总门诊就诊率（95%CI）从 744（737-751）增至 877（872-882）/100 人年，主要是由于除传染病科以外的科室就诊增加。背景人群中门诊就诊率（95%CI）的显著增加使风险比从 16.5（16.2-16.8）降至 7.1（7.0-7.2）。我们观察到癌症相关住院和门诊就诊的相对风险降低，而心血管疾病相关的相对风险略有增加。
HAART 引入后，HIV 感染者的住院治疗减少，尤其是传染病科。相反，该人群在非传染性疾病专科的门诊就诊率增加。
