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Reduction in liver-related hospital admissions and deaths in HIV-infected patients since the year 2002.

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Title: Reduction in liver-related hospital admissions and deaths in HIV-infected patients since the year 2002.
Authors: Martín-Carbonero, L.1, Sánchez-Somolinos, M.1, García-Samaniego, J.2, Núñez, M. J.1, Valencia, M. E.1, González-Lahoz, J.1, Soriano, V.1 vsoriano@dragonet.es
Source: Journal of Viral Hepatitis. Dec2006, Vol. 13 Issue 12, p851-857. 7p. 2 Charts, 2 Graphs.
Subject Terms: *HIV, *HIGHLY active antiretroviral therapy, *HEPATITIS B virus, *HEPATITIS C virus, *LIVER diseases
Abstract: Since the advent of highly active antiretroviral therapy (HAART), complications of chronic liver disease (CLD) have emerged as one of the leading causes of hospital admission and death among HIV-infected patients with chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections. The impact of CLD on hospital admissions and deaths in HIV-infected patients attended at one reference HIV hospital in Madrid during the last 9 years was analysed. All clinical charts from January 1996 to December 2004 were retrospectively examined. Demographics, discharge diagnosis, complications during inhospital stay and causes of death were recorded. A total of 2527 hospital admissions in 2008 distinct HIV-infected persons were recorded. Overall, 84% were iv drug users; mean age was 37 years and the mean CD4 count was 224 cells/ μL. Both mean age and CD4 count significantly increased during the study period ( P < 0.01). Overall, 42% of hospitalized patients were on antiretroviral therapy. Decompensated CLD was the cause of admission and/or developed during hospitalization in 345 patients (14%). Admissions caused by decompensated CLD increased significantly from 9.1% (30/329) in 1996 to 26% (78/294) in 2002. A significant steady decline occurred since then, being 11% (29/253) in the year 2004. Similarly, inhospital liver-related deaths were 9% (5/54) in 1996, peaked to 59% (10/17) in 2001 and declined to 20% (3/15) in the year 2004. Chronic hepatitis C was responsible for admissions and/or deaths in 73.5% of CLD cases. In conclusion, the rate of liver-related hospital admissions and deaths among HIV-infected patients peaked in the year 2002 and has steadily declined since then. A slower progression to liver cirrhosis in patients on HAART, avoidance of hepatotoxic antiretroviral drugs and more frequent use of anti-HCV therapy in HIV/HCV-coinfected patients could account for this benefit. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Viral Hepatitis is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Reduction in liver-related hospital admissions and deaths in HIV-infected patients since the year 2002.
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Journal+of+Viral+Hepatitis%22&quot;&gt;Journal of Viral Hepatitis&lt;/searchLink&gt;. Dec2006, Vol. 13 Issue 12, p851-857. 7p. 2 Charts, 2 Graphs.
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HIV%22&quot;&gt;HIV&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HIGHLY+active+antiretroviral+therapy%22&quot;&gt;HIGHLY active antiretroviral therapy&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HEPATITIS+B+virus%22&quot;&gt;HEPATITIS B virus&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22HEPATITIS+C+virus%22&quot;&gt;HEPATITIS C virus&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22LIVER+diseases%22&quot;&gt;LIVER diseases&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
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  Data: Since the advent of highly active antiretroviral therapy (HAART), complications of chronic liver disease (CLD) have emerged as one of the leading causes of hospital admission and death among HIV-infected patients with chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infections. The impact of CLD on hospital admissions and deaths in HIV-infected patients attended at one reference HIV hospital in Madrid during the last 9 years was analysed. All clinical charts from January 1996 to December 2004 were retrospectively examined. Demographics, discharge diagnosis, complications during inhospital stay and causes of death were recorded. A total of 2527 hospital admissions in 2008 distinct HIV-infected persons were recorded. Overall, 84% were iv drug users; mean age was 37 years and the mean CD4 count was 224 cells/ μL. Both mean age and CD4 count significantly increased during the study period ( P &lt; 0.01). Overall, 42% of hospitalized patients were on antiretroviral therapy. Decompensated CLD was the cause of admission and/or developed during hospitalization in 345 patients (14%). Admissions caused by decompensated CLD increased significantly from 9.1% (30/329) in 1996 to 26% (78/294) in 2002. A significant steady decline occurred since then, being 11% (29/253) in the year 2004. Similarly, inhospital liver-related deaths were 9% (5/54) in 1996, peaked to 59% (10/17) in 2001 and declined to 20% (3/15) in the year 2004. Chronic hepatitis C was responsible for admissions and/or deaths in 73.5% of CLD cases. In conclusion, the rate of liver-related hospital admissions and deaths among HIV-infected patients peaked in the year 2002 and has steadily declined since then. A slower progression to liver cirrhosis in patients on HAART, avoidance of hepatotoxic antiretroviral drugs and more frequent use of anti-HCV therapy in HIV/HCV-coinfected patients could account for this benefit. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of Viral Hepatitis is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder&#39;s express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1111/j.1365-2893.2006.00778.x
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        Text: English
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        PageCount: 7
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    Subjects:
      – SubjectFull: HIV
        Type: general
      – SubjectFull: HIGHLY active antiretroviral therapy
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      – TitleFull: Reduction in liver-related hospital admissions and deaths in HIV-infected patients since the year 2002.
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              Text: Dec2006
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