Rates and risk factors for condition-specific hospitalizations in HIV-infected and uninfected women.
BACKGROUND
The rates and risk factors for overall and medical condition-specific hospitalizations in HIV-positive women have not been examined in detail or compared with rates in risk factor-matched HIV-negative women.


OBJECTIVE
To determine the rates and risk factors for overall and condition-specific hospitalizations.


METHODS
Prospective cohort study of 885 HIV-positive women and 425 HIV-negative women followed for semiannual research visits between 1993 and 2000 in 4 urban locations in the United States. Outcome measures were hospitalization diagnoses with diabetes mellitus, nonacute renal conditions, cardiovascular conditions, liver conditions, AIDS defining conditions, and overall hospitalizations. Clinical and laboratory risk factors were assessed at research visits every 6 months, and effects of risk factors on hospitalization rates were calculated using generalized estimating equations and Poisson regression.


RESULTS
Renal laboratory abnormalities, hypertension, and clinical AIDS were each associated with 3 of the 5 condition-specific hospitalization rates. Over time, diabetes-, nonacute renal-, and cardiovascular-related rates were flat or slightly increased and liver-related rates were significantly increased in HIV-positive women. Hospitalization rates with an AIDS-defining condition declined sharply in the latter half of the study period.


CONCLUSIONS
In this population of largely African-American, inner-city, HIV-infected women, renal abnormalities, hypertension, and hepatitis C virus infection were common. Rate ratios indicated that "non-AIDS" risk factors were important predictors of hospitalization. In the highly active antiretroviral therapy era, clinicians must pay attention to these risk factors for morbidity and should closely monitor renal abnormalities, hypertension, and hepatitis status.
Gardner
Lytt I
LI
Centers for Disease Control, Mailstop E-45, Division of HIV/AIDS, 1600 Clifton Road, NE, Atlanta, GA 30333, USA. lig0@cdc.gov
Klein
Robert S
RS
Szczech
Lynda A
LA
Phelps
Ruby M
RM
Tashima
Karen
K
Rompalo
Anne M
AM
Schuman
Paula
P
Sadek
Ramses F
RF
Tong
Tony C
TC
Greenberg
Alan
A
Holmberg
Scott D
SD
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking; D000914:Antibodies, Viral / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology*; D015497:HIV-1; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007674:Kidney Diseases / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019966:Substance-Related Disorders; D014481:United States / Q000453:epidemiology
D000914:Antibodies, Viral; D012367:RNA, Viral; D003404:Creatinine