Association between Admission Serum Albumin and 12-weeks Mortality in AIDS/HIV Late Diagnosis Patients in Hospital: A Retrospective Cohort Study

Abstract

Abstract Background: Many patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) are still undiagnosed or diagnosed late, which leads to serious consequences and burdens. Low serum albumin levels are significantly correlated with disease prognosis. This study investigated the association between serum albumin concentration and 12-week mortality of HIV/AIDS with late diagnosis in mainland China. Methods: In this single-center retrospective cohort study, 1,079 inpatients with late HIV/AIDS diagnosis between January 2018 and December 2021 were included. The strata of serum albumin levels were categorized into tertiles. Disease progression was estimated using the 12-week mortality. Cox proportional hazards regression models were used to evaluate the serum albumin concentration with disease progression. The Kaplan–Meier method was used to analyze the effect of different serum albumin levels on mortality. Results: During the 12-week follow-up, 77 patients (7.1%) died. Serum albumin concentration was significantly correlated with late HIV/AIDS diagnosis progression. In Cox proportional hazards regression models, the mortality risk decreased by 8% with the increase in every 1g/L serum albumin after adjustment (hazard ratio [HR] = 0.92, 95% confidence interval [CI]: 0.88–0.97). Compared with that of the low serum albumin group (< 28 g/L), the middle group (28–33 g/L) mortality risk decreased by 70% (HR = 0.30, 95% CI: 0.16–0.60), and that of the high group (≥ 34 g/L) decreased by 45% (HR = 0.55, 95% CI: 0.27–1.15) after adjustment. Conclusions: Hospitalized patients with late HIV/AIDS diagnosis and low serum albumin concentrations in mainland China had a relatively high short-term mortality rate. Further research is needed to characterize the role of serum albumin in the timely prevention of 12-week mortality in patients with a late diagnosis.