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Admission for HIV-1 related disease in a Dublin hospital 1987-1990
M Murphy1, N Misquito, L Pomeroy
1Department of Genitourinary Medicine, St James's Hospital, Dublin.
Insights
This study on human immunodeficiency virus type 1 (HIV-1) patients found bacterial lower respiratory infections were the most common admission cause. Many patients presented with advanced (CDC stage IV) disease, often undiagnosed before hospitalization.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Human Immunodeficiency Virus Type 1 (HIV-1) infection presents significant healthcare challenges.
- Intravenous drug use is a major risk factor for HIV-1 transmission and associated complications.
- Bacterial infections, particularly lower respiratory tract infections, are common in advanced HIV-1 disease.
Purpose of the Study:
- To analyze the patterns of hospital admissions for HIV-1 infected patients.
- To identify the primary causes of hospitalization and disease staging at admission.
- To evaluate the length of hospital stay based on disease severity.
Main Methods:
- Retrospective analysis of hospital admission data for HIV-1 positive patients.
- Data collected between January 1987 and December 1990 at St James's Hospital, Dublin.
- Patient demographics, reasons for admission, Centers for Disease Control (CDC) staging, and length of stay were recorded.
Main Results:
- 179 HIV-1 patients accounted for 408 admissions; 73.7% were intravenous drug users.
- Bacterial lower respiratory tract infection was the most frequent admission cause (21%).
- 53% of patients met CDC stage IV criteria, with Pneumocystis carinii pneumonia being a common diagnosis; 26 stage IV patients had unknown HIV status prior to admission.
Conclusions:
- HIV-1 patients, particularly intravenous drug users, frequently required hospitalization for bacterial infections.
- A significant proportion of patients presented with advanced HIV-1 disease (CDC stage IV), highlighting diagnostic and treatment gaps.
- Length of hospital stay was longer for patients with stage IV disease, indicating higher morbidity.
Abstract:
Between January 1987 and December 1990, 179 patients (131 men, 48 women) infected with human immunodeficiency virus type 1 (HIV-1) were admitted 408 times to St James's Hospital, Dublin. One hundred and thirty-two (73.7%) patients were intravenous drug users. The commonest cause of admission was bacterial lower respiratory tract infection (84 patients, 21%). At the time of study 95 (53%) patients fulfilled Centers for Disease Control (CDC) criteria for stage IV disease. HIV antibody status in 26 of these patients with stage IV disease was unknown prior to their admission to hospital with symptomatic disease. Pneumocystis carinii pneumonia was the most frequent stage IV defining diagnosis. The mean length of hospital stay for patients with CDC stage II/III and stage IV disease was 8.5 (median 7) and 13.5 (median 8) days respectively.