A significant proportion of HIV-infected patients admitted to hospital have immunosuppression as a result of failure of highly active antiretroviral therapy.
OBJECTIVE
To investigate the immunological and virological features of patients on highly active antiretroviral therapy (HAART) admitted to a tertiary centre.


METHODS
A retrospective study was carried out on HIV-infected patients on HAART admitted to the Regional Infectious Disease Unit in Edinburgh between June 2002 and July 2003.


RESULTS
A total of 125 patients who had been on HAART for at least 6 months were admitted during the study period. The frequencies of hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfection were 52% (78 of 150 patients) and 48% (72 of 150 patients), respectively (P>0.05 for comparison of frequencies of hepatitis B and C). Of patients who had been on HAART for at least 6 months, 50% (63 of 125 patients) were immuno-suppressed and had significantly higher bed-days 6 (3-12) compared with those with CD4>200 cells/microL (P<0.002). Amongst immuno-suppressed patients, 38% (24 of 63) had undetectable viral load after at least 6 months of therapy. Those patients were mostly (67%) intravenous drug users and had a significantly higher median age (43 years; range 38-47 years) than other patients (P<0.001).


CONCLUSIONS
Earlier start of HAART and addition of interleukin (IL)-2 to the treatment regimens of patients at risk of slow CD4 T-cell count recovery may reduce the duration of their subsequent hospital admissions.
Manavi
K
K
Department of Genitourinary Medicine, Lothian University Hospitals NHS Trust, 39 Lauriston Place, Edinburgh EH3 9HA, Scotland, UK. kaveh.manavi@luht.scot.nhs.uk
McMillan
A
A
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology* / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007108:Immune Tolerance; D007376:Interleukin-2 / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D017211:Treatment Failure; D019562:Viral Load
D019380:Anti-HIV Agents; D007376:Interleukin-2