S. Paul et al., The impact of potent antiretroviral therapy on the characteristics of hospitalized patients with HIV infection, AIDS, 13(3), 1999, pp. 415-418
Objective: Despite advances in antiretroviral treatment, a large number of
HIV-infected patients still require hospitalization. This study describes t
he characteristics of HIV patients requiring hospitalization before and aft
er the advent of potent antiretroviral therapies.
Methods: Information was collected on all HIV-positive patients admitted to
the New York Hospital-Cornell Medical Center in New York City. Data was co
llected from 1 January through 30 June 1995, and during the same 6-month in
terval in 1997.
Results: In each time period over 1500 outpatients were receiving treatment
for HIV infection. There was a significant decrease in the incidence of ad
mission [60.4 per 100 patient-years (PY) in 1995, 28.8 per 100 PY in 1997],
and length of stay (10 versus 8 days). The median CD4 cell count of all HI
V-infected patients admitted to the hospital doubled: 37 x 10(6)/l in 1995
versus 80 x 10(6)/l in 1997. However, there was no significant change in th
e median CD4 cell count of patients diagnosed with opportunistic infections
. The incidence of the most common diagnosis (bacterial pneumonia, 8.0 per
100 PY in 1995 versus 3.6 per 100 PY in 1997) and the most common opportuni
stic infection (Pneumocystis carinii pneumonia 7.6 per 100 PY in 1995 versu
s 2.4 per 100 PY in 1997) decreased significantly.
Conclusions: Since the introduction of potent antiretroviral therapy, a sig
nificant decrease in the incidence of hospital admission and opportunistic
infections has occurred. There has been a doubling of the median CD4 cell c
ount of inpatients. There has been no significant change in the median CD4
cell count at which patients present with opportunistic infections. (C) 199
9 Lippincott Williams & Wilkins.