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Vallecillo G, Mojal S, Torrens M, et al. 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. Open Forum Infect Dis. 2014;1(1):ofu010doi: 10.1093/ofid/ofu010.
Vallecillo, G., Mojal, S., Torrens, M., & Muga, R. (2014). 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. Open forum infectious diseases, 1(1), ofu010. https://doi.org/10.1093/ofid/ofu010
Vallecillo, Gabriel, et al. "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." Open forum infectious diseases vol. 1,1 (2014): ofu010. doi: https://doi.org/10.1093/ofid/ofu010
Vallecillo G, Mojal S, Torrens M, Muga R. 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. Open Forum Infect Dis. 2014 Jun 19;1(1):ofu010. doi: 10.1093/ofid/ofu010. eCollection 2014 Mar. PMID: 25734084; PMCID: PMC4324207.
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Open Forum Infect Dis. 2014 Jun 19;1(1):ofu010. doi: 10.1093/ofid/ofu010. eCollection 2014 Mar.

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.

Open forum infectious diseases

Gabriel Vallecillo, Sergio Mojal, Marta Torrens, Roberto Muga

Affiliations

  1. Departments of Internal Medicine and Drug Addiction Unit of Psychiatry.
  2. Department of Statistics and Operations Research, Parc de Recerca Biomédica de Barcelona, Barcelona, Spain.
  3. Drug Addiction Unit of Psychiatry, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

PMID: 25734084 PMCID: PMC4324207 DOI: 10.1093/ofid/ofu010

Abstract

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.

Keywords: HIV-infected drug users; antiretroviral therapy; hospitalization

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