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  • 标题:Causes and outcome of hospitalization among HIV-infected adults receiving antiretroviral therapy in Mulago hospital, Uganda
  • 本地全文:下载
  • 作者:AMN Namutebi ; MRK Kamya ; P Byakika-Kibwika
  • 期刊名称:African Health Sciences
  • 印刷版ISSN:1680-6905
  • 电子版ISSN:1729-0503
  • 出版年度:2013
  • 卷号:13
  • 期号:4
  • 页码:977-985
  • DOI:10.4314/ahs.v13i4.17
  • 语种:English
  • 出版社:Makerere University Medical School(Uganda)
  • 摘要:Background: Cohorts describing cause specific mortality in HIV-infected patients initiating antiretroviral therapy (ART) operate on an outpatient basis. Hospitalized patients represent the spectrum and burden of severe morbidity and mortality in patients on ART. Objective: To determine the causes and outcomes of hospitalization among adults receiving ART. Methods: A prospective cohort study. We enrolled 201 participants (50% female) with median (IQR) age and CD4 count of 34 (28-40) years and 91(29-211) cells/uL respectively. Results: The most frequent causes of hospitalization were tuberculosis (TB) (37, 18%), cryptococcal meningitis (22, 11%), zidovudine (AZT) - associated anemia (19, 10%), sepsis (10, 5%) and Kaposi’s sarcoma (10, 5%). Forty two patients (21%) died: 10 (24%) had TB, 8 (19%) had cryptococcal meningitis and 5 (12%) had sepsis, 9 (21%) had undiagnosed neurological syndromes while 10 (24%) had other illnesses. Predictors of death included low Karnofsky performance score of < 40 (OR, 21.1; CI 1.43- 31.6) and age >34 years (OR, 7.65; CI 1.09- 53.8). Conclusions: Opportunistic infections, malignancy and AZT-associated anemia contributed to most hospitalizations andm ortality. It is important to intensify prevention, screening, and treatment for these opportunistic diseases and early ART initiation in HIV-infected patients. Tenofovir-based regimens, unless contraindicated should be scaled up to replace AZTbased regimens as first line ART drugs. Africa Health Sciences 2013; 13(4): 977 - 985
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