Antiretroviral therapy (ART) use, human immunodeficiency virus (HIV)-1 rna suppression, and medical causes of hospitalization among HIV-infected intravenous drug users in the late ART era

Gabriel Vallecillo Sánchez, Sergio Mojal, Marta Torrens, Roberto Muga

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3 Citations (Scopus)

Abstract

© The Author 2014. Background. Antiretroviral therapy (ART) has reduced the rates and changed the causes of hospital admission. However, human immunodeficiency virus-positive intravenous drug users (HIV-IDU) continue to have increased hospitalizations and discharge diagnosis are less defined in the late ART era. Our aim was to examine ART use, HIV- 1 RNA suppression, and hospital discharge diagnoses among HIV-IDU admitted to an urban hospital. Methods. A retrospective analysis was made of HIV-IDU admitted for medical causes for the first time (2006-2010). Surgical, obstetric, or mental (except HIV-associated neurocognitive disorder) diagnoses were excluded. Clinical characteristics, number of admissions, and primary discharge diagnoses were determined for each patient. Results. Three hundred and seventy-five admissions were recorded among 197 hospitalized HIV-IDU. Lifetime prevalence of ART use was 83.2% (164 of 197) and the rate of HIV-1 RNA < 50 copies/mL was 38.1% (75 of 197). Primary discharge diagnosis groups were as follows: bacterial infections (59.2%), chronic end-organ damage (16.8%), complications derived from injected drug use (16.8%), malignancies (9.1%), and opportunistic infections (6.6%). Chronic end-organ damage was diagnosed more frequently in patients with HIV-1 RNA < 50 copies/mL (36% vs 4.9%; P <.000), and complications derived from injected drug use (23.8% vs 5.3%; P <.0008) and acquired immune deficiency syndrome (AIDS) opportunistic infections (19.8% vs 1.3% P <.019) were usually diagnosed in patients with HIV-1 RNA detectable viral load. Conclusions. Human immunodeficiency virus-positive intravenous drug users are admitted to hospitals mainly for non-AIDS-related illnesses; however, sustained HIV-1 RNA viral load suppression is poor and determines hospital discharge diagnoses. Providers need to be aware of the management of HIV-related comorbidities and reinforce strategies to improve ART retention in this population.
Original languageEnglish
JournalOpen Forum Infectious Diseases
Volume1
Issue number1
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Antiretroviral therapy
  • HIV-infected drug users
  • Hospitalization

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