1531. Epidemiologic and clinical profile of hospitalized HIV Colombian patients
Session: Poster Abstract Session: HIV: Clinical Care
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Poster HIV.pdf (1001.3 kB)
  • Background:Highly active antiretroviral therapy (HAART) has changed the natural history of HIV-infection; the incidence of opportunistic infections (OIs) and mortality associated to HIV has improved dramatically.

    Methods:Descriptive study of patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia where demographic, laboratory, and clinical data were prospectively collected during one year.

    Results: 553 HIV-infected patients were admitted: 76% were male and the mean age was 39.4 years (SD +12.3). Diagnosis of HIV was made in 21.8% during the index admission,58.4% had a diagnosis for more than one year and 68.9% were diagnosed in an advanced stage of the disease. Prior AIDS-defining conditions were present in 42.4%; the most frequent one was tuberculosis. 63.2% of patients were on HAART at the time of admission, but only 54.1% were adherent. More than 50% of patients had CD4 counts less than 200 CD4 cells/uL and viral loads more than 100,000 copies. The main reasons for hospital admission were OIs; tuberculosis was the most common one (Table 1). The mean hospital stay was 17 (SD 13.9) days. 10.3% of patients required admission to the ICU and 14.3% readmission. Mortality was 5.4%.Table 1 Reason for hospitalization

    Main reason for hospitalization

    N 553

    n(%)

    1. AIDS-defining illness*

    301 (54.4)

    Tuberculosis

    128 (23.2)

    Esophageal candidiasis

    56 (10.1)

    Toxoplasmosis encephalitis

    43 (7.8)

    Diseminated histoplasmosis

    39 (7.1)

    Cytomegalovirus disease

    36 (6.5)

    Cryptococcosis

    32 (5.8)

    P.jiroveci pneumonia

    32 (5.8)

    Others

    79 (14.2)

    2. Adverse reaction to opportunistic infection treatment or HAART

    39 (7.1)

    3. Non AIDS-defining illness or cause not associated with HIV

    213 (38.5)

    *Some patients had more than one AIDS-defining illness

     

    Conclusion: In contrast to developing nations where reasons for admission in HIV patients reflect those of the general population, the majority of HIV-infected patients hospitalized in our city were diagnosed in an advanced stage of the disease and were admitted for OIs. This suggests important barriers in access to testing, care as well as problems with retention in care. Strategies to implement early tuberculosis diagnosis and treatment, as well as to promote retention in care and treatment adherence are desperately needed.

    Maria Alvarez, Resident1, Juan Pablo Villa, Infectious disease resident1, Carlos Agudelo Restrepo, MD, MSc2, Alicia Hidron, MD, DTMH3, Lina Echeverri, MD4, Jaime Mauricio Ramirez, MD4, Adriana Ocampo, MD5, Glenys Porras, MD6, Ivan Trompa, MD7, Laura Restrepo, Medicine Student1, Alejandro Eusse, Medicine Student1 and Carlos Restrepo, MD, MSc8, (1)Universidad Pontificia Bolivariana, Medellin, Colombia, (2)Infectious Diseases, Clínica Universitaria Bolivariana Universidad Pontificia Bolivariana, Medellín, Colombia, (3)Medicine, Universidad Pontificia Bolivariana, Medellin, Colombia, (4)Hospital San Vicente Fundación, Medellin, Colombia, (5)Centros Especializados San Vicente Fundación, Rionegro, Colombia, (6)Hospital General de Medellin, Medellin, Colombia, (7)IPS Universitaria, Clínica León XIII, Medellin, Colombia, (8)Clinica Universitaria Pontificia Bolivariana, Medellin, Colombia

    Disclosures:

    M. Alvarez, None

    J. P. Villa, None

    C. Agudelo Restrepo, None

    A. Hidron, None

    L. Echeverri, None

    J. M. Ramirez, None

    A. Ocampo, None

    G. Porras, None

    I. Trompa, None

    L. Restrepo, None

    A. Eusse, None

    C. Restrepo, None

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