Publication: Hospitalization in South African adolescents with perinatally acquired HIV on antiretroviral therapy
Frigati, L.J. Brown, K. Cotton, M.F. Myer, L. Zar, H.J.
Frigati, L.J.
Brown, K.
Cotton, M.F.
Myer, L.
Zar, H.J.
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Abstract
Background:
Little is known about hospitalization in African adolescents with perinatally acquired HIV (PHIV+ adolescents). We described the incidence and causes of hospitalization in participants enrolled in the Cape Town Adolescent Antiretroviral Cohort in South Africa.
Methods:
Data collected from July 2013 to October 2018 from PHIV+ and HIV− adolescents were analyzed. Participants were assessed every 6 months and data on intercurrent hospitalization were abstracted. Causes of hospitalizations were classified according to ICD-10 codes. Descriptive statistics, time-to-event analysis and Poisson regression were used to describe causes and incidence and to determine incidence rate ratios for factors associated with hospitalization.
Results:
Five hundred fifteen PHIV+ and 109 HIV− participants had a median follow-up of 4.1 years [interquartile range (IQR): 3.7–4.6]. At enrollment HIV+ participants had a median duration of ART of 7.6 years (IQR: 4.6–9.2), median CD4 count of 713 cells/mm3 (IQR: 561.0–957.5) and 387 (75%) had a viral load <50 copies/mL. There were 149 hospital admissions over 64 months. Crude incidence rates for hospitalization were 6.6 [95% confidence interval (CI): 5.7–7.8] and 2.2 (95% CI: 1.2–4.3) per 100-person-years (P = <0.01) in HIV + and HIV−, respectively. Ninety of 149 (60%) admissions in HIV+ participants were classified as non-infectious, 36/149 (24%) were infectious and 23/149 (16%) were “other HIV-related” or “unknown.” Older age (15–19 years) and maintaining a CD4 >500 cells/cm3 were associated with decreased risk of hospitalization: adjusted incidence rate ratios of 0.61 (CI: 0.44–0.86, P = <0.01) and 0.68 (CI: 0.49–0.94, P = 0.02), respectively.
Conclusions:
PHIV+ adolescents had a high incidence of hospitalization despite ART. Strategies addressing infectious and non-infectious morbidity must be strengthened.
Description
Date
2020-05-24
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Wolters Kluwer
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Keywords
Perinatally -acquired HIV,Antiretroviral therapy,Adolescents,South African
Citation
Frigati LJ, Brown K, Cotton MF, Myer L, Zar HJ. Hospitalization in South African Adolescents With Perinatally Acquired HIV on Antiretroviral Therapy. Pediatr Infect Dis J.