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. 2014 May;33(5):488-94.
doi: 10.1097/INF.0000000000000126.

Trends in hospitalizations among children and young adults with perinatally acquired HIV

Stephen A Berry  1 , Kelly A Gebo, Richard M Rutstein, Keri N Althoff, P Todd Korthuis, Aditya H Gaur, Stephen A Spector, Robert Warford, Baligh R Yehia, Allison L Agwu; HIV Research Network
Collaborators, Affiliations

Trends in hospitalizations among children and young adults with perinatally acquired HIV

Stephen A Berry et al. Pediatr Infect Dis J. 2014 May.

Abstract

Background: Contemporary trends in hospitalization patterns among perinatally HIV-infected (PHIV) patients are unknown. We describe rates and reasons for hospitalizations stratified by age group during 2003-2010 within a large cohort of PHIV patients.

Methods: 579 PHIV patients engaged in care at 6 geographically diverse pediatric HIV centers affiliated through the HIV Research Network were included. Modified Clinical Classification Software assigned primary ICD-9 codes into diagnostic categories. Analysis was performed using negative binomial regression with generalized estimating equations.

Results: There were 699 all-cause hospitalizations. The overall rate for the full cohort was 19.9/100 person-years, and overall rates for 0-4, 5-16 and 17-24 year-olds were 25.1, 14.7 and 34.2/100 person-years, respectively. Declines were seen in unadjusted all-cause rates for the whole group [incidence rate ratio per year, 0.93 (0.87-0.99)] and for 5-16 [0.87 (0.76-0.99)] and 17-24 year-olds [0.87 (0.80-0.95)]. After adjustment for CD4, HIV-1 RNA and demographics, rates were no longer declining. Non-AIDS-defining infections and AIDS-defining illnesses together caused 349 (50%) admissions. Declines in these categories drove the overall declines in unadjusted rates. No increases over time were seen for cardiovascular, renal or any other diagnostic categories.

Conclusions: While the declines in hospitalizations are reassuring, continued efforts are needed to address the persistently high infectious and non-infectious morbidity among PHIV patients. Innovative strategies may be most critical for 17-24 year-olds. Lack of increases in cardiovascular and renal admissions provides modest, preliminary reassurance against severe non-infectious complications from longstanding HIV infection and antiretroviral exposure.

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Conflict of interest statement

Conflicts of Interest: RMR, SAS, and RW have none to declare.

Figures

Figure 1
Figure 1
Trends in all-cause hospitalization rate, by age group. Legend: y.o., year-old
See this image and copyright information in PMC

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