497. Increasing Burden of HIV/AIDS on Hospitals in Saskatoon, Saskatchewan, Canada
Session: Poster Abstract Session: HIV Testing and Prevention
Friday, October 21, 2011
Room: Poster Hall B1
Background: The incidence of HIV in Saskatchewan, Canada is the highest in the country, increasing nearly 400% from 2004 to 2009, and disproportionately affects young Aboriginal women and injection drug users (IDU). Despite the availability of effective treatment, a significant number of hospital admissions for HIV/AIDS complications have been noted. The aim of this project is to describe the inpatient burden of HIV/AIDS in Saskatoon, Saskatchewan.

Methods: A retrospective chart review of all non-obstetrical admissions of HIV infected patients to the three hospitals servicing Saskatoon from 1 January 2008 to 31 December 2010 was conducted. HIV-related admissions were defined as AIDS-defining illnesses, acute seroconversion, or complications secondary to HIV. IDU-related admissions were defined as infectious complications of IDU, such as endocarditis, and overdose.

Results: 163 patients accounted for 294 unique admissions totaling 6,184 days, of which 2,564 days were HIV-related and 2,052 were IDU-related. HIV-related admissions increased from 20 in 2008 to 39 in 2010. 38 patients (23.3%) were newly diagnosed with HIV in hospital. Average age at first admission was 37.7 years (range 18-65), females accounted for 45.4%, and 96 patients (61.5%) were active injection drug users. Mean admission CD4 count was 215 cells/mm3. Of the 96 patients who were aware of their status and had CD4 counts <350 cells/mm3, only 30 (29.1%) were receiving antiretrovirals.  Overall mortality during the study period was 15.3%, and for those patients with HIV-related admissions, 16/60 (26.7%) died.

Conclusion: The increasing incidence of HIV in Saskatchewan, especially in marginalized populations, is accompanied by substantial HIV-related morbidity and mortality. In Saskatoon, HIV infected patients are commonly admitted to hospital with advanced disease, low CD4 counts and no antiretroviral therapy. Late diagnosis and low usage of antiretrovirals indicate a lack of access to and engagement into care. This study indicates a critical need for resources to prevent HIV transmission, reduce morbidity and mortality and engage patients into care in Saskatoon, Saskatchewan.

 


Subject Category: H. HIV/AIDS and other retroviruses

Karsten Hammond, MD1, Michelle Persaud, MD2, Oscar E. Larios, MD3, Karen McClean, MD3, Athena McConnell, MD4, Stephen Sanche, MD3, Satchan Takaya, MD5, Ben Tan, MD4, Kurt Williams, MD3 and Stuart Skinner, MD3, (1)University of Calgary, Calgary, AB, Canada, (2)University of Saskatchewan, Saskatoon, SK, Canada, (3)Division of Infectious Diseases, University of Saskatchewan, Saskatoon, SK, Canada, (4)Pediatrics, University of Saskatchewan, Saskatoon, SK, Canada, (5)Infectious Diseases, St. Paul's Hospital, Saskatoon, SK, Canada

Disclosures:

K. Hammond, None

M. Persaud, None

O. E. Larios, None

K. McClean, None

A. McConnell, None

S. Sanche, None

S. Takaya, None

B. Tan, None

K. Williams, None

S. Skinner, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.