Mahlab-Guri Keren, Asher Ilan, Bezalel-Rosenberg Shira, Elbirt Daniel, Sthoeger Zev M
The Department of Allergy, Clinical Immunology and AIDS Kaplan Medical Center, Rehovot, Israel. Affiliated to the Hebrew University and Hadasa Medical School, Jerusalem, Israel.
Medicine (Baltimore). 2017 May;96(18):e6812. doi: 10.1097/MD.0000000000006812.
To evaluate hospitalization rates and causes among human immunodeficiency virus (HIV) patients in the late highly active antiretroviral therapy (HAART) era. Data during the years 2000 to 2012 were obtained from hospital/clinical charts. Hospitalizations were defined as a ≥24 hours hospital admission. Obstetric admissions were excluded. Causes of hospitalizations were defined as acquired immune deficiency syndrome (AIDS)-defining illnesses, AIDS-related diseases (HAART adverse events, metabolic complications and non-AIDS-defining tumors/infections), and non-HIV-related diseases. Hospitalization rates are presented as admissions per 100 patient years. The number of HIV patients (58% males) in our center increased from 521 in 2000 to 1169 in 2012. 1676 hospital admissions (in 557 patients) were observed during the years of the study. The mean number of admissions per hospitalized patient was 3 ± 3.39. Hospitalization rates of HIV patients declined significantly (18.4/100 in 2000, 9/100 patient years in 2012; P = .0001), but it was higher than the rates reported in the Israeli general population (X8.76 in 2000, X6.04 in 2012). Furthermore, hospitalizations for AIDS-defining illness declined (from 46.9% to 16.1%) whereas non-HIV-related hospitalizations increased (from 31.3% to 60.1%). Lower cluster of differentiation 4 (CD4) cell counts and older age, at the time of HIV diagnosis, were associated with higher rates of admissions (especially for AIDS-defining illnesses) and mortality. Hospitalization rates of HIV patients, especially for AIDS-defining illness, continue to decline in the late HAART era despite the increasing age of the patients, though it is still higher than that of the general population. Low CD4 cell counts and older age, at the time of HIV diagnosis, are associated with readmissions and mortality.
评估高效抗逆转录病毒治疗（HAART）后期人类免疫缺陷病毒（HIV）患者的住院率及病因。2000年至2012年期间的数据来自医院/临床病历。住院定义为住院时间≥24小时。产科住院病例排除在外。住院病因定义为获得性免疫缺陷综合征（AIDS）界定疾病、AIDS相关疾病（HAART不良事件、代谢并发症及非AIDS界定肿瘤/感染）以及非HIV相关疾病。住院率以每100患者年的入院次数表示。我们中心的HIV患者数量（男性占58%）从2000年的521例增加至2012年的1169例。在研究期间观察到1676次住院（涉及557例患者）。每位住院患者的平均入院次数为3±3.39次。HIV患者的住院率显著下降（2000年为18.4/100，2012年为9/100患者年；P = 0.0001），但高于以色列普通人群报告的住院率（2000年为8.76，2012年为6.04）。此外，AIDS界定疾病的住院率下降（从46.9%降至16.1%），而非HIV相关住院率上升（从31.3%升至60.1%）。HIV诊断时较低的分化抗原4（CD4）细胞计数及较高年龄与较高的入院率（尤其是AIDS界定疾病）及死亡率相关。尽管患者年龄增加，但在HAART后期，HIV患者的住院率，尤其是AIDS界定疾病的住院率仍持续下降，不过仍高于普通人群。HIV诊断时低CD4细胞计数及较高年龄与再次入院及死亡率相关。
