Causes of hospital admission of AIDS patients in southern Brazil, 2007 to 2012

Guerro, Anna Caroline; Andretta, Iliana Barbosa; Bello, Soraya Lamin; Trevisol, Daisson José; Schuelter-Trevisol, Fabiana

doi:10.1590/0037-8682-0235-2013

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Short Communications • Rev. Soc. Bras. Med. Trop. 47 (05) • Sep-Oct 2014 • https://doi.org/10.1590/0037-8682-0235-2013 copy

Causes of hospital admission of AIDS patients in southern Brazil, 2007 to 2012

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction

The acquired immunodeficiency syndrome (AIDS) epidemic is a worldwide phenomenon that has been modified with the implementation of effective antiretroviral therapy. The objective of this study was to determine the leading causes of hospitalization among human immunodeficiency virus (HIV)-positive individuals.

Methods

A cross-sectional study with patients admitted to a general hospital in southern Brazil, between January 2007 and May 2012.

Results

Medical records of 550 hospital admissions (230 patients) were reviewed, with an average of 2.4 hospitalizations per patient. Infectious diseases were the most prevalent causes of hospitalization. Overall, 44.8% patients died and their deaths were associated with longer hospital stays.

Conclusions

Opportunistic infections remained the leading causes of hospitalization.

Acquired immunodeficiency syndrome; Hospitalization; AIDS-related opportunistic infections

Characteristics	Total		Death		PR (95% CI)	p-value
Characteristics	n	%	n	%	PR (95% CI)	p-value
Gender
female	75	32.6	36	35.0	1.0
male	155	67.4	67	65.0	0.97 (0.88–1.06)	0.493
Age (years)
4-19	5	2.1	1	1.0	0.88 (0.63–1.25)	0.485
20-39	106	46.1	51	49.5	1.09 (0.90–1.33)	0.381
40-59	105	45.7	46	44.7	1.06 (0.87–1.29)	0.563
≥60	14	6.1	5	4.9	1.0
Place of residence
Tubarão	122	53.0	53	51.5	1.43 (1.35–1.53)	<0.001
nearby towns	106	46.1	50	48.5	1.47 (1.38–1.57)	<0.001
other states or country	2	0.9	0	0.0	1.0
Marital status
single/divorced/widowed	152	66.4	66	64.1	0.97 (0.88–1.06)	0.504
married/concubinary	77	33.6	37	35.9	1.0
Education (years)
≤8	175	76.4	80	77.7	1.02 (0.92–1.14)	0.687
>8	54	23.6	23	22.3	1.0

Diseases or reasons for hospitalization	Number	Percentage
HIV/AIDS-defining events^* *International Classification of Diseases: B20 to B24, F02.4, R75, Z11.4, Z20.6, Z21, and Z71.7.	314	40.0
Parasitic/infectious diseases	260	33.2
Digestive system diseases	43	5.5
Nervous system diseases/manifestations	43	5.5
Nonspecific symptoms	37	4.8
Pulmonary diseases	26	3.3
Cardiovascular diseases	12	1.5
Nutritional alterations	12	1.5
Renal disorders	12	1.5
Others^ Others: psychotic disorders, convalescence after surgery, acute poisoning, finger injury without nail injury, lupus erythematous, personal history of substance abuse, personal history of other physical traumas. Some patients had more than one diagnostic cause for hospitalization.	11	1.4
Reproductive system diseases	7	0.9
Hematologic diseases	6	0.8
Dermatological manifestations	1	0.1
Total	784	100.0

ICD^* *Some patients were associated with more than one ICD code.	Definitions	Number	Percentage
B20	HIV resulting in infectious and parasitic diseases	32	10.1
B20.0	HIV infections resulting in mycobacterial infection	19	6.1
B20.1	HIV resulting in other bacterial infections	19	6.1
B20.2	HIV disease resulting in cytomegaloviral disease	9	2.9
B20.3	HIV resulting in other viral infections	5	1.6
B20.4	HIV resulting in candidiasis	15	4.8
B20.5	HIV resulting in other mycoses	2	0.6
B20.6	HIV resulting in Pneumocystis jirovecii pneumonia	21	6.7
B20.7	HIV resulting in multiple infections	4	1.3
B20.8	HIV resulting in other infectious and parasitic diseases	3	1.0
B20.9	HIV disease resulting in unspecified infectious or parasitic disease	7	2.2
B21	HIV resulting in malignant neoplasms	1	0.3
B21.0	HIV resulting in a Kaposi sarcoma	1	0.3
B21.2	HIV resulting in other types of non-Hodgkin lymphoma	3	1.0
B22	HIV resulting in other specified diseases	17	5.4
B22.0	HIV resulting in encephalopathy	28	8.9
B23	HIV resulting in other conditions	27	8.6
B23.0	Acute HIV infection syndrome	3	1.0
B23.1	HIV resulting in (persistent) generalized lymphadenopathy	1	0.3
B23.2	HIV resulting in hematological and immunological abnormalities not elsewhere classified	1	0.3
B23.8	HIV resulting in other specified conditions	2	0.6
B24	unspecified HIV disease	94	29.9
Total		314	100.0

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[1] Address to:Dr^a Fabiana Schuelter-Trevisol. Av. José Acácio Moreira 787, Bairro Dehon, 88704-900 Tubarão, SC, Brasil. Phone: 55 48 3631-7239; 55 48 3621-3363. e-mail: fastrevisol@gmail.com