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, M. John Gill, Heidi M. Crane, Vincent C. Marconi, Ronald J. Bosch, Jonathan A. Colasanti, Timothy R. Sterling, W. Christopher Mathews, Angel M. Mayor, Ni Gusti Ayu Nanditha, Kate Buchacz, Jun Li, Peter F. RebeiroJennifer 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, Richard D. Moore, 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, Joseph J. Eron, Sonia Napravnik, Mari M. Kitahata, Heidi M. Crane, Timothy R. Sterling, David Haas, Peter Rebeiro, Megan Turner, Janet Tate, Robert Dubrow, David Fiellin, Richard D. Moore, Keri N. Althoff, Stephen J. Gange, Mari M. Kitahata, Michael S. Saag, Michael A. Horberg, Marina B. Klein, Rosemary G. McKaig, Aimee M. Freeman, Richard D. Moore, Keri N. Althoff, Aimee M. Freeman, Mari M. Kitahata, Stephen E. Van Rompaey, Heidi M. Crane, Liz Morton, Justin McReynolds, William B. Lober, Stephen J. Gange, Keri N. Althoff, Jennifer S. Lee, Bin You, Brenna Hogan, Jinbing Zhang, Jerry Jing, Elizabeth Humes, Lucas Gerace, Sally Coburn

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

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 languageEnglish (US)
Pages (from-to)2113-2123
Number of pages11
JournalJournal of Infectious Diseases
Volume223
Issue number12
DOIs
StatePublished - Jun 15 2021

Keywords

  • cohort studies
  • HIV
  • hospitalization

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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