Abstract
Introduction
Optimal management of critically ill HIV-positive patients during hospitalization and after discharge is not fully understood. This study describes patient characteristics and outcomes of critically ill HIV-positive patients hospitalized in Conakry, Guinea between August 2017 and April 2018 at discharge and 6 months post-discharge.
Methods
We carried out a retrospective observational cohort study using routine clinical data. Analytic statistics were used to describe characteristics and outcomes.
Results
401 patients were hospitalized during the study period, 230 (57%) were female, median age was 36 (IQR: 28–45). At admission, 229 patients (57%) were on ART, median CD4 was 64 cells/mm3, 166 (41%) had a VL >1000 copies/ml, and 97 (24%) had interrupted treatment. 143 (36%) patients died during hospitalisation. Tuberculosis was the major cause of death for 102 (71%) patients. Of 194 patients that were followed after hospitalization a further 57 (29%) were lost-to-follow-up (LTFU) and 35 (18%) died, 31 (89%) of which had a TB diagnosis. Of all patients who survived a first hospitalisation, 194 (46%) were re-hospitalised at least once more. Amongst those LTFU, 34 (59%) occurred immediately after hospital discharge.
Conclusion
Outcomes for critically ill HIV-positive patients in our cohort were poor. We estimate that 1-in-3 patients remained alive and in care 6 months after their hospital admission. This study shows the burden of disease on a contemporary cohort of patients with advanced HIV in a low prevalence, resource limited setting and identifies multiple challenges in their care both during hospitalisation as well as during and after re-transitioning to ambulatory care.
Publisher
Public Library of Science (PLoS)
Reference35 articles.
1. Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment;L Ferradini;Lancet Lond Engl,2006
2. UNAIDS Global report 2010 | UNAIDS Report on the global AIDS epidemic 2010 [Internet]. 2017 [cited 2017 Sep 15]. http://www.unaids.org/globalreport/Global_report.htm
3. Managing Advanced HIV Disease in a Public Health Approach;N Ford;Clin Infect Dis Off Publ Infect Dis Soc Am,2018
4. Rapport Le Prix de l’oubli—Des millions de personnes en Afrique occidentale et centrale restent en marge de la lutte mondiale contre le VIH [Internet]. Médecins sans frontières. [cited 2019 Jul 29]. https://www.msf.fr/communiques-presse/rapport-le-prix-de-l-oubli-des-millions-de-personnes-en-afrique-occidentale-et-centrale-restent-en-marge-de-la-lutte.
5. UNAIDS data 2018 [Internet]. [cited 2019 Jul 30]. https://www.unaids.org/en/resources/documents/2018/unaids-data-2018.
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