Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015

Thibaut Davy-Mendez; Sonia Napravnik; Brenna C. Hogan; Keri N. Althoff; Kelly A. Gebo; Richard D. Moore; Michael A. Horberg; Michael J. Silverberg; Heidi M. Crane; Vincent C. Marconi; Ronald J. Bosch; Jonathan A. Colasanti; W. Christopher Mathews; Angel M. Mayor; Ni Gusti Ayu Nanditha; Kate Buchacz; Jun Li; Peter F. Rebeiro; Jennifer E. Thorne; Ank Nijhawan; David Van Duin; David A. Wohl; Joseph J. Eron; Stephen A. Berry; Constance A. Benson; Ronald J. Bosch; Gregory D. Kirk; Kenneth H. Mayer; Chris Grasso; Robert S. Hogg; P. Richard Harrigan; Julio S.G. Montaner; Benita Yip; Julia Zhu; Kate Salters; Karyn Gabler; Kate Buchacz; Jun Li; Kelly A. Gebo; John T. Carey; Benigno Rodriguez; Michael A. Horberg; Michael J. Silverberg; Jennifer E. Thorne; Todd Brown; Phyllis Tien; Gypsyamber D'Souza; Charles Rabkin; Marina B. Klein; Abigail Kroch; Ann Burchell; Adrian Betts; Joanne Lindsay; Robert F. Hunter-Mellado; Angel M. Mayor; M. John Gill; Jeffrey N. Martin; Jun Li; John T. Brooks; Michael S. Saag; Michael J. Mugavero; James Willig; William C. Mathews; Sonia Napravnik; Mari M. Kitahata; Heidi M. Crane; Timothy R. Sterling; David Haas; Peter Rebeiro; Megan Turner; Janet Tate; Robert Dubrow; David Fiellin; Stephen J. Gange; Mari M. Kitahata; Michael S. Saag; Michael A. Horberg; Rosemary G. McKaig; Aimee M. Freeman; Aimee M. Freeman; Mari M. Kitahata; Stephen E. Van Rompaey; Heidi M. Crane; Liz Morton; Justin McReynolds; William B. Lober; Stephen J. Gange; Jennifer S. Lee; Bin You; Brenna Hogan; Jinbing Zhang; Jerry Jing; Elizabeth Humes; Lucas Gerace; Sally Coburn

doi:10.1093/infdis/jiaa661

Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015

Thibaut Davy-Mendez, Sonia Napravnik, Brenna C. Hogan, Keri N. Althoff, Kelly A. Gebo, Richard D. Moore, Michael A. Horberg, Michael J. Silverberg, Heidi M. Crane, Vincent C. Marconi, Ronald J. Bosch, Jonathan A. Colasanti, W. Christopher Mathews, Angel M. Mayor, Ni Gusti Ayu Nanditha, Kate Buchacz, Jun Li, Peter F. Rebeiro, Jennifer E. Thorne, Ank NijhawanDavid Van Duin, David A. Wohl, Joseph J. Eron, Stephen A. Berry, Constance A. Benson, Ronald J. Bosch, Gregory D. Kirk, Kenneth H. Mayer, Chris Grasso, Robert S. Hogg, P. Richard Harrigan, Julio S.G. Montaner, Benita Yip, Julia Zhu, Kate Salters, Karyn Gabler, Kate Buchacz, Jun Li, Kelly A. Gebo, John T. Carey, Benigno Rodriguez, Michael A. Horberg, Michael J. Silverberg, Jennifer E. Thorne, Todd Brown, Phyllis Tien, Gypsyamber D'Souza, Charles Rabkin, Marina B. Klein, Abigail Kroch, Ann Burchell, Adrian Betts, Joanne Lindsay, Robert F. Hunter-Mellado, Angel M. Mayor, M. John Gill, Jeffrey N. Martin, Jun Li, John T. Brooks, Michael S. Saag, Michael J. Mugavero, James Willig, William C. Mathews, Sonia Napravnik, Mari M. Kitahata, Heidi M. Crane, Timothy R. Sterling, David Haas, Peter Rebeiro, Megan Turner, Janet Tate, Robert Dubrow, David Fiellin, Stephen J. Gange, Mari M. Kitahata, Michael S. Saag, Michael A. Horberg, Rosemary G. McKaig, Aimee M. Freeman, Aimee M. Freeman, Mari M. Kitahata, Stephen E. Van Rompaey, Heidi M. Crane, Liz Morton, Justin McReynolds, William B. Lober, Stephen J. Gange, Jennifer S. Lee, Bin You, Brenna Hogan, Jinbing Zhang, Jerry Jing, Elizabeth Humes, Lucas Gerace, Sally Coburn

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Abstract

Background: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015. Methods: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL. Results: Among 28057 patients (125724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/μL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories. Conclusions: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.

Original language	English (US)
Pages (from-to)	2113-2123
Number of pages	11
Journal	Journal of Infectious Diseases
Volume	223
Issue number	12
DOIs	https://doi.org/10.1093/infdis/jiaa661
State	Published - Jun 15 2021

Keywords

HIV
cohort studies
hospitalization

ASJC Scopus subject areas

General Medicine

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10.1093/infdis/jiaa661

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Davy-Mendez, T., Napravnik, S., Hogan, B. C., Althoff, K. N., Gebo, K. A., Moore, R. D., Horberg, M. A., Silverberg, M. J., Crane, H. M., Marconi, V. C., Bosch, R. J., Colasanti, J. A., Mathews, W. C., Mayor, A. M., Nanditha, N. G. A., Buchacz, K., Li, J., Rebeiro, P. F., Thorne, J. E., ... Coburn, S. (2021). Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015. Journal of Infectious Diseases, 223(12), 2113-2123. https://doi.org/10.1093/infdis/jiaa661

Davy-Mendez, T, Napravnik, S, Hogan, BC, Althoff, KN, Gebo, KA, Moore, RD, Horberg, MA, Silverberg, MJ, Crane, HM, Marconi, VC, Bosch, RJ, Colasanti, JA, Mathews, WC, Mayor, AM, Nanditha, NGA, Buchacz, K, Li, J, Rebeiro, PF, Thorne, JE, Nijhawan, A, Van Duin, D, Wohl, DA, Eron, JJ, Berry, SA, Benson, CA, Bosch, RJ, Kirk, GD, Mayer, KH, Grasso, C, Hogg, RS, Harrigan, PR, Montaner, JSG, Yip, B, Zhu, J, Salters, K, Gabler, K, Buchacz, K, Li, J, Gebo, KA, Carey, JT, Rodriguez, B, Horberg, MA, Silverberg, MJ, Thorne, JE, Brown, T, Tien, P, D'Souza, G, Rabkin, C, Klein, MB, Kroch, A, Burchell, A, Betts, A, Lindsay, J, Hunter-Mellado, RF, Mayor, AM, John Gill, M, Martin, JN, Li, J, Brooks, JT, Saag, MS, Mugavero, MJ, Willig, J, Mathews, WC, Napravnik, S, Kitahata, MM, Crane, HM, Sterling, TR, Haas, D, Rebeiro, P, Turner, M, Tate, J, Dubrow, R, Fiellin, D, Gange, SJ, Kitahata, MM, Saag, MS, Horberg, MA, McKaig, RG, Freeman, AM, Freeman, AM, Kitahata, MM, Van Rompaey, SE, Crane, HM, Morton, L, McReynolds, J, Lober, WB, Gange, SJ, Lee, JS, You, B, Hogan, B, Zhang, J, Jing, J, Humes, E, Gerace, L & Coburn, S 2021, 'Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015', Journal of Infectious Diseases, vol. 223, no. 12, pp. 2113-2123. https://doi.org/10.1093/infdis/jiaa661

@article{9197e3944d014eefb2543f646d545661,

title = "Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015",

abstract = "Background: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015. Methods: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL. Results: Among 28057 patients (125724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/μL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories. Conclusions: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.",

keywords = "HIV, cohort studies, hospitalization",

author = "Thibaut Davy-Mendez and Sonia Napravnik and Hogan, {Brenna C.} and Althoff, {Keri N.} and Gebo, {Kelly A.} and Moore, {Richard D.} and Horberg, {Michael A.} and Silverberg, {Michael J.} and Crane, {Heidi M.} and Marconi, {Vincent C.} and Bosch, {Ronald J.} and Colasanti, {Jonathan A.} and Mathews, {W. Christopher} and Mayor, {Angel M.} and Nanditha, {Ni Gusti Ayu} and Kate Buchacz and Jun Li and Rebeiro, {Peter F.} and Thorne, {Jennifer E.} and Ank Nijhawan and {Van Duin}, David and Wohl, {David A.} and Eron, {Joseph J.} and Berry, {Stephen A.} and Benson, {Constance A.} and Bosch, {Ronald J.} and Kirk, {Gregory D.} and Mayer, {Kenneth H.} and Chris Grasso and Hogg, {Robert S.} and Harrigan, {P. Richard} and Montaner, {Julio S.G.} and Benita Yip and Julia Zhu and Kate Salters and Karyn Gabler and Kate Buchacz and Jun Li and Gebo, {Kelly A.} and Carey, {John T.} and Benigno Rodriguez and Horberg, {Michael A.} and Silverberg, {Michael J.} and Thorne, {Jennifer E.} and Todd Brown and Phyllis Tien and Gypsyamber D'Souza and Charles Rabkin and Klein, {Marina B.} and Abigail Kroch and Ann Burchell and Adrian Betts and Joanne Lindsay and Hunter-Mellado, {Robert F.} and Mayor, {Angel M.} and {John Gill}, M. and Martin, {Jeffrey N.} and Jun Li and Brooks, {John T.} and Saag, {Michael S.} and Mugavero, {Michael J.} and James Willig and Mathews, {William C.} and Sonia Napravnik and Kitahata, {Mari M.} and Crane, {Heidi M.} and Sterling, {Timothy R.} and David Haas and Peter Rebeiro and Megan Turner and Janet Tate and Robert Dubrow and David Fiellin and Gange, {Stephen J.} and Kitahata, {Mari M.} and Saag, {Michael S.} and Horberg, {Michael A.} and McKaig, {Rosemary G.} and Freeman, {Aimee M.} and Freeman, {Aimee M.} and Kitahata, {Mari M.} and {Van Rompaey}, {Stephen E.} and Crane, {Heidi M.} and Liz Morton and Justin McReynolds and Lober, {William B.} and Gange, {Stephen J.} and Lee, {Jennifer S.} and Bin You and Brenna Hogan and Jinbing Zhang and Jerry Jing and Elizabeth Humes and Lucas Gerace and Sally Coburn",

note = "Publisher Copyright: {\textcopyright} 2020 Published by Oxford University Press for the Infectious Diseases Society of America 2020.",

year = "2021",

month = jun,

day = "15",

doi = "10.1093/infdis/jiaa661",

language = "English (US)",

volume = "223",

pages = "2113--2123",

journal = "Journal of Infectious Diseases",

issn = "0022-1899",

publisher = "Oxford University Press",

number = "12",

}

TY - JOUR

T1 - Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015

AU - Davy-Mendez, Thibaut

AU - Napravnik, Sonia

AU - Hogan, Brenna C.

AU - Althoff, Keri N.

AU - Gebo, Kelly A.

AU - Moore, Richard D.

AU - Horberg, Michael A.

AU - Silverberg, Michael J.

AU - Crane, Heidi M.

AU - Marconi, Vincent C.

AU - Bosch, Ronald J.

AU - Colasanti, Jonathan A.

AU - Mathews, W. Christopher

AU - Mayor, Angel M.

AU - Nanditha, Ni Gusti Ayu

AU - Buchacz, Kate

AU - Li, Jun

AU - Rebeiro, Peter F.

AU - Thorne, Jennifer E.

AU - Nijhawan, Ank

AU - Van Duin, David

AU - Wohl, David A.

AU - Eron, Joseph J.

AU - Berry, Stephen A.

AU - Benson, Constance A.

AU - Bosch, Ronald J.

AU - Kirk, Gregory D.

AU - Mayer, Kenneth H.

AU - Grasso, Chris

AU - Hogg, Robert S.

AU - Harrigan, P. Richard

AU - Montaner, Julio S.G.

AU - Yip, Benita

AU - Zhu, Julia

AU - Salters, Kate

AU - Gabler, Karyn

AU - Buchacz, Kate

AU - Li, Jun

AU - Gebo, Kelly A.

AU - Carey, John T.

AU - Rodriguez, Benigno

AU - Horberg, Michael A.

AU - Silverberg, Michael J.

AU - Thorne, Jennifer E.

AU - Brown, Todd

AU - Tien, Phyllis

AU - D'Souza, Gypsyamber

AU - Rabkin, Charles

AU - Klein, Marina B.

AU - Kroch, Abigail

AU - Burchell, Ann

AU - Betts, Adrian

AU - Lindsay, Joanne

AU - Hunter-Mellado, Robert F.

AU - Mayor, Angel M.

AU - John Gill, M.

AU - Martin, Jeffrey N.

AU - Li, Jun

AU - Brooks, John T.

AU - Saag, Michael S.

AU - Mugavero, Michael J.

AU - Willig, James

AU - Mathews, William C.

AU - Napravnik, Sonia

AU - Kitahata, Mari M.

AU - Crane, Heidi M.

AU - Sterling, Timothy R.

AU - Haas, David

AU - Rebeiro, Peter

AU - Turner, Megan

AU - Tate, Janet

AU - Dubrow, Robert

AU - Fiellin, David

AU - Gange, Stephen J.

AU - Kitahata, Mari M.

AU - Saag, Michael S.

AU - Horberg, Michael A.

AU - McKaig, Rosemary G.

AU - Freeman, Aimee M.

AU - Kitahata, Mari M.

AU - Van Rompaey, Stephen E.

AU - Crane, Heidi M.

AU - Morton, Liz

AU - McReynolds, Justin

AU - Lober, William B.

AU - Gange, Stephen J.

AU - Lee, Jennifer S.

AU - You, Bin

AU - Hogan, Brenna

AU - Zhang, Jinbing

AU - Jing, Jerry

AU - Humes, Elizabeth

AU - Gerace, Lucas

AU - Coburn, Sally

PY - 2021/6/15

Y1 - 2021/6/15

N2 - Background: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015. Methods: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL. Results: Among 28057 patients (125724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/μL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories. Conclusions: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.

AB - Background: To assess the possible impact of antiretroviral therapy improvements, aging, and comorbidities, we examined trends in all-cause and cause-specific hospitalization rates among persons with HIV (PWH) from 2005 to 2015. Methods: In 6 clinical cohorts, we followed PWH in care (≥1 outpatient CD4 count or HIV load [VL] every 12 months) and categorized ICD codes of primary discharge diagnoses using modified Clinical Classifications Software. Poisson regression estimated hospitalization rate ratios for calendar time trends, adjusted for demographics, HIV risk factor, and annually updated age, CD4, and VL. Results: Among 28057 patients (125724 person-years), from 2005 to 2015, the median CD4 increased from 389 to 580 cells/μL and virologic suppression from 55% to 85% of patients. Unadjusted all-cause hospitalization rates decreased from 22.3 per 100 person-years in 2005 (95% confidence interval [CI], 20.6-24.1) to 13.0 in 2015 (95% CI, 12.2-14.0). Unadjusted rates decreased for almost all diagnostic categories. Adjusted rates decreased for all-cause, cardiovascular, and AIDS-defining conditions, increased for non-AIDS-defining infection, and were stable for most other categories. Conclusions: Among PWH with increasing CD4 counts and viral suppression, unadjusted hospitalization rates decreased for all-cause and most cause-specific hospitalizations, despite the potential effects of aging, comorbidities, and cumulative exposure to HIV and antiretrovirals.

KW - HIV

KW - cohort studies

KW - hospitalization

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UR - http://www.scopus.com/inward/citedby.url?scp=85108386494&partnerID=8YFLogxK

U2 - 10.1093/infdis/jiaa661

DO - 10.1093/infdis/jiaa661

M3 - Article

C2 - 33084891

AN - SCOPUS:85108386494

SN - 0022-1899

VL - 223

SP - 2113

EP - 2123

JO - Journal of Infectious Diseases

JF - Journal of Infectious Diseases

IS - 12

ER -

Hospitalization Rates and Causes among Persons with HIV in the United States and Canada, 2005-2015

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