Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008-2018 in Italy
Autor: | Silvia, Nozza, Laura, Timelli, Annalisa, Saracino, Nicola, Gianotti, Claudia, Lazzaretti, Alessandro, Tavelli, Massimo, Puoti, Sergio, Lo Caputo, Andrea, Antinori, Antonella d'Arminio, Monforte, Cristina, Mussini, Enrico, Girardi, On Behalf Of Icona Foundation Study Group |
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Přispěvatelé: | Nozza, S, Timelli, L, Saracino, A, Gianotti, N, Lazzaretti, C, Tavelli, A, Puoti, M, Caputo, S, Antinori, A, D'Arminio Monforte, A, Mussini, C, Girardi, E |
Rok vydání: | 2021 |
Předmět: |
0301 basic medicine
Cart medicine.medical_specialty 030106 microbiology Population Disease Article 03 medical and health sciences symbols.namesake 0302 clinical medicine Acquired immunodeficiency syndrome (AIDS) Internal medicine medicine 030212 general & internal medicine Poisson regression Family history education hospitalizations education.field_of_study business.industry Incidence (epidemiology) non-AIDS defining conditions PLWHIV General Medicine medicine.disease Hospitalization Cohort symbols Medicine business Non-AIDS defining condition |
Zdroj: | Journal of Clinical Medicine Journal of Clinical Medicine, Vol 10, Iss 3391, p 3391 (2021) Volume 10 Issue 15 |
ISSN: | 2077-0383 |
Popis: | Background: We aimed to describe the change in the incidence and causes of hospitalization between 2008 and 2018 among persons living with HIV (PLWHIV) who started antiretroviral therapy (ART) from 2008 onwards in Italy. Methods: We included participants in the ICONA (Italian Cohort Naïve Antiretrovirals) cohort who started ART in 2008. All the hospitalizations occurring during the first 30 days from the start of ART were excluded. Hospitalizations were classified as due to: AIDS-defining conditions (ADC), non-ADC infections and non-infections/non-ADC (i.e., cardiovascular, pulmonary, renal-genitourinary, cancers, gastrointestinal-liver, psychiatric and other diseases). Comparisons of rates across time were assessed using Poisson regression. The Poisson multivariable model evaluated risk factors for hospitalizations, including both demographic and clinical characteristics. Results: A total of 9524 PLWHIV were included 6.8% were drug users, 48.9% men-who-have sex with men (MSM), 39.6% heterosexual contacts 80.8% were males, 42.3% smokers, 16.6% coinfected with HCV and 6.8% with HBV (HBsAg-positive). During 36,157 person-years of follow-up (PYFU), there were 1058 hospitalizations in 747 (7.8%) persons they had HIV-RNA > 50 copies mL in 34.9% and CD4 < 200/mmc in 27%. Causes of hospitalization were 23% ADC, 22% non-ADC infections, 55% non-infections/non-ADC (11% cancers 9% gastrointestinal-liver 6% cardiovascular 5% renal-genitourinary 5% psychiatric 4% pulmonary 15% other). Over the study period, the incidence rate (IR) decreased significantly (from 5.8 per 100 PYFU in 2008–2011 to 2.21 per 100 PYFU in 2016–2018). Age > 50 years, intravenous drug use (IDU), family history of cardiovascular disease, HIV-RNA > 50, CD4 < 200, were associated with a higher hospitalization risk. Conclusions: In our population of PLWHIV, the rate of hospitalization decreased over time. |
Databáze: | OpenAIRE |
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