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P90 Hospitalisation in HIV patients: are the causes of admission changing?
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  1. Catherine Kirby,
  2. Marie-Pier Lirette,
  3. Martin Fisher
  1. Lawson Unit, Brighton, UK

Abstract

Background With an ageing HIV cohort and increasing use of antiretroviral (ART) therapy it may be expected that HIV associated morbidity causing hospitalisation is changing.

Aim To describe hospital admissions over 2 years, and compare this to 2006 data to ascertain if there has been any change.

Methods Retrospective case review of HIV admissions during 2013–14. Patient diagnoses were classified as AIDS related, HIV related, ART toxicity related, and non-HIV related, with one main admission diagnosis.

Results 286 patients were hospitalised during 2013–14, accounting for 458 admissions. Mean age was 48 years, and 71% (203/286) of patients were on ART on admission. 35% (99/286) patients were admitted more than once in the same calendar year. CD4 count was <200 cells/mm3 in 25% of admissions. 15% (69/458) were admitted for AIDS related causes compared with 20% reported in our 2006 data (p = 0.23). Pneumocystis pneumonia (PCP) was the commonest diagnosis, comprising 33% (23/69) of AIDS admissions. 40% (185/458) of admissions were HIV related, including bacterial causes which accounted for 31% (142/458) of all admissions. Non-HIV causes accounted for 45% (204/458) of hospitalisations. There were no admissions for ART toxicity.

Discussion The number of admissions in HIV patients remains high, with a fifth of patients severely immunocompromised on admission. Although admissions secondary to AIDS-defining diagnoses have decreased this is not statistically significant. There is a need to improve strategic HIV testing to prevent late diagnosis and AIDS related conditions, with increased promotion and access of testing in non-GU settings.

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