A longitudinal analysis of hospitalization and emergency department use among human immunodeficiency virus-infected women reporting protease inhibitor use

The impact of protease inhibitors (PIs) on emergency department (i.e., emer gency room [ER]) visits and hospitalizations was examined among a cohort of human immunodeficiency virus (HIV)-infected and high-risk women followed-u p in the HIV Epidemiology Research Study (HERS) from 1993 through 1999. The rates of hospitalization and ER visits were measured as a function of rece nt or current PI use, age, race, transmission risk category, HERS site, bas eline CD4 cell count, and baseline virus load; the PI effect was estimated separately by baseline CD4 cell count. In the HERS, PI use was strongly ass ociated with lower rates of ER visits and hospitalizations for patients wit h baseline CD4 cell counts of <200 cells/mL (for hospitalizations: rate rat io [RR], 0.54; 95% confidence interval [CI], 0.33-0.89; for ER visits: RR, 0.38; 95% CI, 0.24-0.61). Other factors associated with increased hospitali zation and ER use included history of injection drug use, low CD4 cell coun ts, and high virus loads.