TY - JOUR
T1 - Toxoplasmosis Encephalitis
T2 - A Cross-Sectional Analysis at a U.S. Safety-Net Hospital in the Late cART Era
AU - Lau, Abby
AU - Jain, Mamta Khandelwal
AU - Chow, Jeremy Yan Shun
AU - Kitchell, Ellen
AU - Lazarte, Susana
AU - Nijhawan, Ank
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: UT Southwestern Medical Center has received research funding from Gilead Sciences, GSK/Viiv, Merck, Janssen on behalf of research conducted by MKJ.
Publisher Copyright:
© The Author(s) 2021.
PY - 2021
Y1 - 2021
N2 - Despite decreasing incidence of toxoplasmosis encephalitis(TE) among people living with HIV(PLWH) in the late antiretroviral era, U.S. safety-net hospitals still see significant numbers of admissions for TE. Little is known about this population, their healthcare utilization and long-term outcomes. We conducted an 8-year retrospective review of PLWH with TE at a safety-net hospital. Demographics, clinical characteristics, treatments, readmissions, and outcomes were collected. We used chi-squared test to evaluate 6-month all-cause readmission and demographic/clinical characteristics. Of 38 patients identified, 79% and 40% had a new diagnosis of TE and HIV respectively. 59% had 6-month all-cause readmission. Social factors were associated with readmission (uninsured (p = 0.036), Spanish as primary language (p = 0.017), non-adherence (p = 0.030)) and not markers of clinical severity (ICU admission, steroid-use, concomitant infections, therapeutic adverse events). Despite high readmission rates, at follow-up, 60% had a complete response, 30% had a partial response. Improving TE outcomes requires focus on culturally competent, coordinated care.
AB - Despite decreasing incidence of toxoplasmosis encephalitis(TE) among people living with HIV(PLWH) in the late antiretroviral era, U.S. safety-net hospitals still see significant numbers of admissions for TE. Little is known about this population, their healthcare utilization and long-term outcomes. We conducted an 8-year retrospective review of PLWH with TE at a safety-net hospital. Demographics, clinical characteristics, treatments, readmissions, and outcomes were collected. We used chi-squared test to evaluate 6-month all-cause readmission and demographic/clinical characteristics. Of 38 patients identified, 79% and 40% had a new diagnosis of TE and HIV respectively. 59% had 6-month all-cause readmission. Social factors were associated with readmission (uninsured (p = 0.036), Spanish as primary language (p = 0.017), non-adherence (p = 0.030)) and not markers of clinical severity (ICU admission, steroid-use, concomitant infections, therapeutic adverse events). Despite high readmission rates, at follow-up, 60% had a complete response, 30% had a partial response. Improving TE outcomes requires focus on culturally competent, coordinated care.
KW - HIV/AIDS
KW - Latino/Hispanic
KW - health disparities
KW - readmissions
KW - toxoplasmosis encephalitis
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U2 - 10.1177/23259582211043863
DO - 10.1177/23259582211043863
M3 - Article
C2 - 34663116
AN - SCOPUS:85117351314
SN - 2325-9574
VL - 20
JO - Journal of the International Association of Providers of AIDS Care
JF - Journal of the International Association of Providers of AIDS Care
ER -