Mortality & clinical characteristics of hospitalized adult patients with HIV in Pune, India.
OBJECTIVE
In India, data regarding mortality and clinical characteristics of hospitalized HIV-infected patients are sparse, which may limit the effectiveness of new hospital-based HIV programmes providing antiretroviral therapy (ART). The objective of our study was to determine mortality and clinical characteristics of hospitalized HIV-infected individuals in a high HIV prevalence region of India.


METHODS
A retrospective chart review was done of known HIV-infected adults admitted to the Medical Service of a large, public hospital in Pune, India, from January 2002 to November 2003.


RESULTS
A total of 655 HIV-infected patients were identified; 489 (74.7%) were male and 4 (0.6%) were on ART. The most common illnesses reported were tuberculosis (55.8%), diarrhoea (4.2%), and alcoholic liver disease (3.7%) . The inpatient mortality was 172 (26.3%). The most common causes of death of the 172 people were tuberculosis (52.9%) and cryptococcal meningitis (7.6%). In multivariate analysis, factors associated with increased mortality were male sex (adjusted odds ratio (AOR) 1.92, 95% CI: 1.08-3.41), haemoglobin level < 7 g/dl (AOR 2.75, 95% CI:1.23-6.14), length of stay < 2 days (OR 5.78, 95%, CI: 1.82-18.4), and cryptococcal meningitis (OR 4.44, 95% CI:1.19-16.6).


CONCLUSIONS
In the era prior to widespread ART, a high inpatient mortality of 26 per cent was found among hospitalized HIV-infected individuals. Thus, while hospitalization is an important access and referral point for HIV care and treatment, earlier identification of HIV-infected persons must occur to ensure they will optimally benefit from the government's ART programme.
Sobhani
Ramona
R
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Basavaraj
Anita
A
Gupta
Amita
A
Bhave
Ashok S
AS
Kadam
Dilip B
DB
Sangle
Shashikala A
SA
Prasad
Haridas B
HB
Choi
Joline
J
Josephs
Joshua
J
Gebo
Kelly A
KA
Morde
Shweta N
SN
Bollinger
Robert C
RC
Kakrani
Arjun L
AL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D003967:Diarrhea / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D008108:Liver Diseases, Alcoholic / Q000150:complications; D008297:Male; D016919:Meningitis, Cryptococcal / Q000150:complications / Q000401:mortality; D008875:Middle Aged; D012189:Retrospective Studies; D014376:Tuberculosis / Q000150:complications / Q000401:mortality
D044966:Anti-Retroviral Agents