3rd International AIDS Society Conference on HIV Pathogenesis and Treatment Rio de Janeiro - July 24 - 27, 2005

REDUCTION IN LIVER-RELATED HOSPITAL ADMISSIONS AND DEATHS IN HIV+ PATIENTS SINCE YEAR 2001

IAS Conf HIV Pathog Treat 2005 Jul 24-27;3rd: Abstract No. TuPe1.1C32

Sanchez-Somolinos M.¹, Martin-Carbonero L.¹, Valencia M.E.¹, Samaniego J.¹, Romero M.¹, Nuñez M.J.², González-Lahoz J.¹, Soriano V.^1
1Hospital Carlos III, Madrid, Spain, ²Hospital de Fuenlabrada, Madrid, Spain

Since the advent of HAART, complications of chronic viral liver disease (CVLD) have emerged as one of the leading causes of hospital admission and death in HIV+ patients with HCV and/or HBV. We assess the impact of CVLD on hospital admissions and death in HIV+ patients attended during the last 9 years at one reference hospital in Madrid. A retrospective review of all clinical charts from Jan 1996 to Dec 2004 was carried out. Demographics, discharge diagnosis, complications during inhospital stay, and causes of death were examined. A total of 2514 hospital admissions in 1998 HIV+ persons were recorded. Overall, 82% were iv drug users; mean age 38-years old; and mean CD4 count 232 cells/ml. Both mean age and CD4 counts significantly increased during the study period (p<0.01). Overall, 44% of hospitalized patients were on antiretroviral therapy. Decompensated CVLD was the cause of hospital admission and/or developed during hospitalization in 344 patients (14%). Admissions caused by decompensated CVLD significantly increased from 9.1% (30/329) in 1996 to 15% (44/294) in 2001. However, a significant decrease occurred since then, being of 11% (28/247) in 2004. Admissions due to hepatotoxicity of HAART increased significantly since 2000, while typical episodes of end-stage CVLD diminished. Overall, liver-related complications currently are the 2nd cause of hospital admission for HIV+ patients, following bacterial respiratory infections and preceding tuberculosis. Chronic hepatitis C is by far involved in most cases of CVLD in our series. Liver-related deaths increased from 9% (5/54) in 1996 to 53% (9/17) in 2001, but steadily declined since then, being of 23% (4/17) in 2004. The rate of liver-related hospital admissions and deaths among HIV+ patients peaked in year 2001, and have steadily declined since then.

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050724
Clinical | TuPe1.1C32 | Mar Sanchez-Somolinos
Hepatitis viruses

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