Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy
Background: We aimed to describe the change in the incidence and causes of hospitalization between 2008 and 2018 among persons living with HIV (PLWHIV) who started antiretroviral therapy (ART) from 2008 onwards in Italy. Methods: We included participants in the ICONA (Italian Cohort Naïve Antiretrov...
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| Format: | Article |
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MDPI AG
2021-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/15/3391 |
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| author | Silvia Nozza Laura Timelli Annalisa Saracino Nicola Gianotti Claudia Lazzaretti Alessandro Tavelli Massimo Puoti Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Cristina Mussini Enrico Girardi on behalf of ICONA Foundation Study Group |
| author_facet | Silvia Nozza Laura Timelli Annalisa Saracino Nicola Gianotti Claudia Lazzaretti Alessandro Tavelli Massimo Puoti Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Cristina Mussini Enrico Girardi on behalf of ICONA Foundation Study Group |
| author_sort | Silvia Nozza |
| collection | DOAJ |
| description | Background: We aimed to describe the change in the incidence and causes of hospitalization between 2008 and 2018 among persons living with HIV (PLWHIV) who started antiretroviral therapy (ART) from 2008 onwards in Italy. Methods: We included participants in the ICONA (Italian Cohort Naïve Antiretrovirals) cohort who started ART in 2008. All the hospitalizations occurring during the first 30 days from the start of ART were excluded. Hospitalizations were classified as due to: AIDS-defining conditions (ADC), non-ADC infections and non-infections/non-ADC (i.e., cardiovascular, pulmonary, renal-genitourinary, cancers, gastrointestinal-liver, psychiatric and other diseases). Comparisons of rates across time were assessed using Poisson regression. The Poisson multivariable model evaluated risk factors for hospitalizations, including both demographic and clinical characteristics. Results: A total of 9524 PLWHIV were included; 6.8% were drug users, 48.9% men-who-have sex with men (MSM), 39.6% heterosexual contacts; 80.8% were males, 42.3% smokers, 16.6% coinfected with HCV and 6.8% with HBV (HBsAg-positive). During 36,157 person-years of follow-up (PYFU), there were 1058 hospitalizations in 747 (7.8%) persons; they had HIV-RNA >50 copies mL in 34.9% and CD4 < 200/mmc in 27%. Causes of hospitalization were 23% ADC, 22% non-ADC infections, 55% non-infections/non-ADC (11% cancers; 9% gastrointestinal-liver; 6% cardiovascular; 5% renal-genitourinary; 5% psychiatric; 4% pulmonary; 15% other). Over the study period, the incidence rate (IR) decreased significantly (from 5.8 per 100 PYFU in 2008–2011 to 2.21 per 100 PYFU in 2016–2018). Age > 50 years, intravenous drug use (IDU), family history of cardiovascular disease, HIV-RNA > 50, CD4 < 200, were associated with a higher hospitalization risk. Conclusions: In our population of PLWHIV, the rate of hospitalization decreased over time. |
| first_indexed | 2024-03-10T09:12:38Z |
| format | Article |
| id | doaj.art-03d5c04403124771a2901ddf14e4f0ab |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T09:12:38Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-03d5c04403124771a2901ddf14e4f0ab2023-11-22T05:50:04ZengMDPI AGJournal of Clinical Medicine2077-03832021-07-011015339110.3390/jcm10153391Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in ItalySilvia Nozza0Laura Timelli1Annalisa Saracino2Nicola Gianotti3Claudia Lazzaretti4Alessandro Tavelli5Massimo Puoti6Sergio Lo Caputo7Andrea Antinori8Antonella d’Arminio Monforte9Cristina Mussini10Enrico Girardi11on behalf of ICONA Foundation Study GroupDepartment of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milano, ItalyNational Institute for Infectious Diseases L. Spallanzani, IRCCS, 00077 Rome, ItalyInfectious Diseases Department, Università degli Studi di Bari, 70126 Bari, ItalyDepartment of Infectious Diseases, San Raffaele Scientific Institute, 20127 Milano, ItalyCilinic of Infectious Diseases, Arcispedale Santa Maria Nuova, 42123 Reggio Emilia, ItalyICONA Foundation, 20126 Milano, ItalyDepartment of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda, 20126 Milano, ItalyInfectious Diseaes Department, University of Foggia, 71122 Foggia, ItalyNational Institute for Infectious Diseases L. Spallanzani, IRCCS, 00077 Rome, ItalyDepartment of Health Sciences, Clinic of Infectious Diseases, ASST Santi Paolo e Carlo, University of Milan, 20126 Milano, ItalyCilinic of Infectious Diseases, Arcispedale Santa Maria Nuova, 42123 Reggio Emilia, ItalyNational Institute for Infectious Diseases L. Spallanzani, IRCCS, 00077 Rome, ItalyBackground: We aimed to describe the change in the incidence and causes of hospitalization between 2008 and 2018 among persons living with HIV (PLWHIV) who started antiretroviral therapy (ART) from 2008 onwards in Italy. Methods: We included participants in the ICONA (Italian Cohort Naïve Antiretrovirals) cohort who started ART in 2008. All the hospitalizations occurring during the first 30 days from the start of ART were excluded. Hospitalizations were classified as due to: AIDS-defining conditions (ADC), non-ADC infections and non-infections/non-ADC (i.e., cardiovascular, pulmonary, renal-genitourinary, cancers, gastrointestinal-liver, psychiatric and other diseases). Comparisons of rates across time were assessed using Poisson regression. The Poisson multivariable model evaluated risk factors for hospitalizations, including both demographic and clinical characteristics. Results: A total of 9524 PLWHIV were included; 6.8% were drug users, 48.9% men-who-have sex with men (MSM), 39.6% heterosexual contacts; 80.8% were males, 42.3% smokers, 16.6% coinfected with HCV and 6.8% with HBV (HBsAg-positive). During 36,157 person-years of follow-up (PYFU), there were 1058 hospitalizations in 747 (7.8%) persons; they had HIV-RNA >50 copies mL in 34.9% and CD4 < 200/mmc in 27%. Causes of hospitalization were 23% ADC, 22% non-ADC infections, 55% non-infections/non-ADC (11% cancers; 9% gastrointestinal-liver; 6% cardiovascular; 5% renal-genitourinary; 5% psychiatric; 4% pulmonary; 15% other). Over the study period, the incidence rate (IR) decreased significantly (from 5.8 per 100 PYFU in 2008–2011 to 2.21 per 100 PYFU in 2016–2018). Age > 50 years, intravenous drug use (IDU), family history of cardiovascular disease, HIV-RNA > 50, CD4 < 200, were associated with a higher hospitalization risk. Conclusions: In our population of PLWHIV, the rate of hospitalization decreased over time.https://www.mdpi.com/2077-0383/10/15/3391hospitalizationsPLWHIVnon-AIDS defining conditions |
| spellingShingle | Silvia Nozza Laura Timelli Annalisa Saracino Nicola Gianotti Claudia Lazzaretti Alessandro Tavelli Massimo Puoti Sergio Lo Caputo Andrea Antinori Antonella d’Arminio Monforte Cristina Mussini Enrico Girardi on behalf of ICONA Foundation Study Group Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy Journal of Clinical Medicine hospitalizations PLWHIV non-AIDS defining conditions |
| title | Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy |
| title_full | Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy |
| title_fullStr | Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy |
| title_full_unstemmed | Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy |
| title_short | Decrease in Incidence Rate of Hospitalizations Due to AIDS-Defining Conditions but Not to Non-AIDS Conditions in PLWHIV on cART in 2008–2018 in Italy |
| title_sort | decrease in incidence rate of hospitalizations due to aids defining conditions but not to non aids conditions in plwhiv on cart in 2008 2018 in italy |
| topic | hospitalizations PLWHIV non-AIDS defining conditions |
| url | https://www.mdpi.com/2077-0383/10/15/3391 |
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