Many Hospitalized HIV Patients Have Immunosuppression Resulting from Failure of HAART

The objective of this retrospective study was to investigate the immunological and virological features of patients on HAART admitted to a tertiary center. The study was conducted among 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.

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/L (P<0.002).

Among 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.

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.

09/24/04

Reference
K Manavi and A McMillan. A significant proportion of HIV-infected patients admitted to hospital have immunosuppression as a result of failure of highly active antiretroviral therapy. HIV Medicine 5(5): 360-363. September 2004.