Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh.
Predictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh.The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh.A study was conducted in the HIV in-patient un...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2014-01-01
|
| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4259303?pdf=render |
| _version_ | 1818583042566914048 |
|---|---|
| author | Lubaba Shahrin Daniel T Leung Nashaba Matin Mohammed Moshtaq Pervez Tasnim Azim Pradip Kumar Bardhan James D Heffelfinger Mohammod Jobayer Chisti |
| author_facet | Lubaba Shahrin Daniel T Leung Nashaba Matin Mohammed Moshtaq Pervez Tasnim Azim Pradip Kumar Bardhan James D Heffelfinger Mohammod Jobayer Chisti |
| author_sort | Lubaba Shahrin |
| collection | DOAJ |
| description | Predictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh.The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh.A study was conducted in the HIV in-patient unit (Jagori Ward) of icddr,b's Dhaka Hospital. Characteristics of patients who died during hospitalization were compared to those of patients discharged from the ward. Bivariate analysis was performed to determine associations between potential risk factors and death. Multivariable logistic regression was used to identify factors independently associated with death.Of 293 patients admitted to the Jagori Ward, 57 died during hospitalization. Most hospitalized patients (67%) were male and the median age was 35 (interquartile range: 2-65) years. Overall, 153 (52%) patients were diagnosed with HIV within 6 months of hospitalization. The most common presumptive opportunistic infections (OIs) identified were tuberculosis (32%), oesophageal candidiasis (9%), Pneumocystis jirovecii pneumonia (PJP) (8%), and histoplasmosis (7%). On multivariable analysis, independent predictors of mortality were CD4 count ≤200 cells/mm3 (adjusted odds ratio [aOR]: 16.6, 95% confidence interval [CI]: 3.7-74.4), PJP (aOR: 18.5, 95% CI: 4.68-73.3), oesophageal candidiasis (aOR: 27.5, 95% CI: 5.5-136.9), malignancy (aOR:15.2, 95% CI: 2.3-99.4), and bacteriuria (aOR:7.9, 95% CI: 1.2-50.5). Being on antiretroviral therapy prior to hospitalization (aOR: 0.2, 95% CI: 0.06-0.5) was associated with decreased mortality.This study showed that most patients who died during hospitalization on the Jagori Ward had HIV-related illnesses which could have been averted with earlier diagnosis of HIV and proper management of OIs. It is prudent to develop a national HIV screening programme to facilitate early identification of HIV. |
| first_indexed | 2024-12-16T07:58:59Z |
| format | Article |
| id | doaj.art-e13f298a5e334a8c8b23e71a90a635ac |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-16T07:58:59Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-e13f298a5e334a8c8b23e71a90a635ac2022-12-21T22:38:40ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-01912e11309510.1371/journal.pone.0113095Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh.Lubaba ShahrinDaniel T LeungNashaba MatinMohammed Moshtaq PervezTasnim AzimPradip Kumar BardhanJames D HeffelfingerMohammod Jobayer ChistiPredictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh.The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh.A study was conducted in the HIV in-patient unit (Jagori Ward) of icddr,b's Dhaka Hospital. Characteristics of patients who died during hospitalization were compared to those of patients discharged from the ward. Bivariate analysis was performed to determine associations between potential risk factors and death. Multivariable logistic regression was used to identify factors independently associated with death.Of 293 patients admitted to the Jagori Ward, 57 died during hospitalization. Most hospitalized patients (67%) were male and the median age was 35 (interquartile range: 2-65) years. Overall, 153 (52%) patients were diagnosed with HIV within 6 months of hospitalization. The most common presumptive opportunistic infections (OIs) identified were tuberculosis (32%), oesophageal candidiasis (9%), Pneumocystis jirovecii pneumonia (PJP) (8%), and histoplasmosis (7%). On multivariable analysis, independent predictors of mortality were CD4 count ≤200 cells/mm3 (adjusted odds ratio [aOR]: 16.6, 95% confidence interval [CI]: 3.7-74.4), PJP (aOR: 18.5, 95% CI: 4.68-73.3), oesophageal candidiasis (aOR: 27.5, 95% CI: 5.5-136.9), malignancy (aOR:15.2, 95% CI: 2.3-99.4), and bacteriuria (aOR:7.9, 95% CI: 1.2-50.5). Being on antiretroviral therapy prior to hospitalization (aOR: 0.2, 95% CI: 0.06-0.5) was associated with decreased mortality.This study showed that most patients who died during hospitalization on the Jagori Ward had HIV-related illnesses which could have been averted with earlier diagnosis of HIV and proper management of OIs. It is prudent to develop a national HIV screening programme to facilitate early identification of HIV.http://europepmc.org/articles/PMC4259303?pdf=render |
| spellingShingle | Lubaba Shahrin Daniel T Leung Nashaba Matin Mohammed Moshtaq Pervez Tasnim Azim Pradip Kumar Bardhan James D Heffelfinger Mohammod Jobayer Chisti Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. PLoS ONE |
| title | Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. |
| title_full | Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. |
| title_fullStr | Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. |
| title_full_unstemmed | Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. |
| title_short | Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh. |
| title_sort | characteristics and predictors of death among hospitalized hiv infected patients in a low hiv prevalence country bangladesh |
| url | http://europepmc.org/articles/PMC4259303?pdf=render |
| work_keys_str_mv | AT lubabashahrin characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT danieltleung characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT nashabamatin characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT mohammedmoshtaqpervez characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT tasnimazim characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT pradipkumarbardhan characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT jamesdheffelfinger characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh AT mohammodjobayerchisti characteristicsandpredictorsofdeathamonghospitalizedhivinfectedpatientsinalowhivprevalencecountrybangladesh |