Epidemiological differences and risk factors for hospitalization in people living with HIV in Istanbul, Turkey

Abstract

We aimed to determine the risk factors for hospitalization in treatment-naïve people living with HIV (PLHIV) and also the frequency of HIV-related comorbidities in hospitalized patients. Sociodemographic, clinical, and laboratory findings of treatment-naïve PLHIV followed up in our department between January 2015 and July 2018 were retrospectively evaluated and risk factors for hospitalization at initial presentation were analyzed. A total of 629 patients were included. In all, 558 patients (88.7%) were male and 326 (51.8%) were men who have sex with men (MSM), and 8.6% of all patients were hospitalized at initial presentation. When comparing outpatient and inpatient groups, the mean age (p < 0.001), rates of having heterosexual (HS) intercourse (p < 0.001), low education level (p < 0.001), late presenters (p < 0.001), and CD4 cell count < 50 cells/mm3 (p < 0.001) were significantly higher in the inpatient group. In logistic regression analysis, older age and CD4 T lymphocyte count < 50 cells/mm3 were found to be independent risk factors for hospitalization. Among hospitalized patients, 55.5% had oropharyngeal/esophageal candidiasis, 38.9% had tuberculosis, corresponding to a HIV-related comorbidity in 118 patients, among whom a mortality rate of 9.2% was detected. The rate of hospitalization was high among our patients. The majority of the hospitalized patients were HS individuals with a relatively older age who had low educational level. A lower rate of hospitalizations in a higher risk group such as MSM suggests that educational and preventive activities are required to increase awareness and to encourage HIV testing, not only in high-risk groups, but also in the general population.