Internal Medicine Department, General University Hospital of Alicante-ISABIAL & Miguel Hernández University of Elche.
Emergency Department, General University Hospital of Alicante-ISABIAL.
AIDS. 2022 Feb 1;36(2):249-256. doi: 10.1097/QAD.0000000000003105.
The prognosis of HIV infection dramatically improved after the introduction of triple antiretroviral therapy 25 years ago. Herein, we report the impact of further improvements in HIV management since then, looking at all hospitalizations in persons with HIV (PWH) in Spain.
A retrospective study using the Spanish National Registry of Hospital Discharges. Information was retrieved since 1997-2018.
From 79 647 783 nationwide hospital admissions recorded during the study period, 532 668 (0.67%) included HIV as diagnosis. The mean age of PWH hospitalized increased from 33 to 51 years (P < 0.001). The rate of HIV hospitalizations significantly declined after 2008. Comparing hospitalizations during the first (1997-2007) and last (2008-2018) decades, the rate of non-AIDS illnesses increased, mostly due to liver disease (from 35.9 to 38.3%), cardiovascular diseases (from 12.4 to 28.2%), non-AIDS cancers (from 6.4 to 15.5%), and kidney insufficiency (from 5.4 to 13%). In-hospital deaths occurred in 5.5% of PWH, declining significantly over time. Although most deaths were the result from AIDS conditions (34.8%), the most frequent non-AIDS deaths were liver disease (47.1%), cardiovascular events (29.2%), non-AIDS cancers (24.2%), and kidney insufficiency (20.7%).
Hospital admissions in PWH significantly declined after 2008, following improvements in HIV management and antiretroviral therapy. Non-AIDS cancers, cardiovascular events and liver disease represent a growing proportion of hospital admissions and deaths in PWH.
25 年前，三重抗逆转录病毒疗法的引入极大地改善了 HIV 感染的预后。在此，我们报告自那时以来 HIV 管理的进一步改进的影响，观察西班牙所有 HIV 感染者（PWH）的住院情况。
使用西班牙国家住院患者登记处进行回顾性研究。自 1997 年至 2018 年期间检索信息。
在研究期间记录的全国范围内 79647783 例住院治疗中，有 532668 例（0.67%）包括 HIV 作为诊断。住院治疗的 PWH 年龄从 33 岁增加到 51 岁（P<0.001）。2008 年后，HIV 住院率显著下降。比较第一个十年（1997-2007 年）和最后一个十年（2008-2018 年）的住院治疗，非艾滋病疾病的发生率增加，主要是由于肝脏疾病（从 35.9%增加到 38.3%），心血管疾病（从 12.4%增加到 28.2%），非艾滋病癌症（从 6.4%增加到 15.5%）和肾功能不全（从 5.4%增加到 13%）。PWH 的院内死亡率为 5.5%，随时间显著下降。尽管大多数死亡是 AIDS 状况的结果（34.8%），但最常见的非艾滋病死亡原因是肝脏疾病（47.1%），心血管事件（29.2%），非艾滋病癌症（24.2%）和肾功能不全（20.7%）。
2008 年后，随着 HIV 管理和抗逆转录病毒治疗的改善，PWH 的住院治疗显著下降。非艾滋病癌症、心血管事件和肝脏疾病在 PWH 的住院和死亡中占比越来越大。
