Hospitalization Rates Among People With HIV/AIDS in New York City, 2013

Lazar, Rachael; Kersanske, Laura; Xia, Qiang; Daskalakis, Demetre; Braunstein, Sarah L.

doi:10.1093/cid/cix343

Cited by 32 publications

(44 citation statements)

References 20 publications

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“…Because of combined antiretroviral therapy (ART), in the last decades the epidemiology of HIV has changed from high mortality by opportunistic infections in AIDS to long-term non-infectious complication of HIV infection ( 84 , 85 ). However, even though sustained virologic control is achieved by ART, people living with HIV still experience increased mortality associated with higher rates of long-term comorbidities including cardiovascular diseases, depression, HIV-associated neurocognitive disorders, and non-AIDS cancers ( 86 – 90 ). Many of long-term complications in HIV-infected individuals are related to continuing immune suppression ( 87 , 91 , 92 ) and/or sustained inflammation ( 93 – 95 ).…”

Section: Platelet Activation In the Pathophysiology Of Viral Infectiomentioning

confidence: 99%

“…Many of long-term complications in HIV-infected individuals are related to continuing immune suppression ( 87 , 91 , 92 ) and/or sustained inflammation ( 93 – 95 ). Ischemic thrombotic and cardiovascular events represent some of the most frequent long-term complications and leading cause of death among virologically suppressed HIV-infected subjects ( 86 , 89 , 91 , 92 , 96 , 97 ). Considering the potential role for platelets in the cardiovascular risk of people living with HIV, much attention has been given on the implications of platelet activation in the pathogenesis of HIV infection.…”

Section: Platelet Activation In the Pathophysiology Of Viral Infectiomentioning

confidence: 99%

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Platelets in Immune Response to Virus and Immunopathology of Viral Infections

2018

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Platelets are essential effector cells in hemostasis. Aside from their role in coagulation, platelets are now recognized as major inflammatory cells with key roles in the innate and adaptive arms of the immune system. Activated platelets have key thromboinflammatory functions linking coagulation to immune responses in various infections, including in response to virus. Recent studies have revealed that platelets exhibit several pattern recognition receptors (PRR) including those from the toll-like receptor, NOD-like receptor, and C-type lectin receptor family and are first-line sentinels in detecting and responding to pathogens in the vasculature. Here, we review the main mechanisms of platelets interaction with viruses, including their ability to sustain viral infection and replication, their expression of specialized PRR, and activation of thromboinflammatory responses against viruses. Finally, we discuss the role of platelet-derived mediators and platelet interaction with vascular and immune cells in protective and pathophysiologic responses to dengue, influenza, and human immunodeficiency virus 1 infections.

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Section: Platelet Activation In the Pathophysiology Of Viral Infectiomentioning

confidence: 99%

Section: Platelet Activation In the Pathophysiology Of Viral Infectiomentioning

confidence: 99%

Platelets in Immune Response to Virus and Immunopathology of Viral Infections

2018

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“…A diagnosis of HIV was based on the presence of International Classification of Diseases, Ninth Revision, Clinical Modification codes (ICD-9) 042, 079.53, 795.71, and V08 in the principal or secondary diagnosis fields. These codes were used in prior studies of HIV in administrative data [15][16][17]. CPR was identified based on the presence of ICD-9 codes 99.60 or 99.63 [8,18].…”

Section: Data Sources and Study Populationmentioning

confidence: 99%

“…First, use of administrative data may have led to misclassification of some of the examined hospitalizations. However, similar approach was used in prior other epidemiological studies [8,15,16]. Second, although we adjusted for a broad array of patient-and hospital-level covariates, the dataset did not include information on the duration of HIV infection, use of cART, control of HIV replication, CD4 + T-cell counts, the hospital setting of cardiac arrest (e.g., general wards vs. monitored beds, or ICU) or, as noted earlier, the processes of care during and following CPR.…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

In-Hospital Cardiopulmonary Resuscitation of Patients With Human Immunodeficiency Virus Infection: A Population-Based Cohort Study of Epidemiology and Outcomes

Oud

2020

J Clin Med Res

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Background: Marked improvements were realized in both shortterm and long-term outcomes of human immunodeficiency virus (HIV)-infected patients following the introduction of combination antiretroviral therapy. However, the contemporary population-level patterns of in-hospital cardiopulmonary resuscitation (CPR) and the outcomes of HIV-infected patients were not systematically examined. Methods:We used the Texas Inpatient Public Use Data File to identify hospitalizations aged ≥ 18 years with and without HIV during 2009 -2014, and those in each group who have undergone in-hospital CPR. Short-term survival (defined as absence of hospital mortality or discharge to hospice) following in-hospital CPR was examined. Multivariate logistic regression modeling was used to assess the prognostic impact of HIV infection following in-hospital CPR and predictors of short-term survival among HIV hospitalizations. Results:In-hospital CPR was reported in 437 and 54,135 hospitalizations with and without HIV, respectively. The rates of in-hospital CPR (per 1,000 hospitalizations) were 4.4 and 4.1 among hospitalizations with and without HIV, respectively (P = 0.1659). The corresponding rates of in-hospital CPR among decedents were 11% and 11.8%, respectively (P = 0.1531). Crude short-term survival following in-hospital CPR among hospitalizations with and without HIV was 19% and 26.8%, respectively (P = 0.0003). The corresponding adjusted short-term survival between 2009 and 2014 rose from 14.2% to 27% (P = 0.0009 for trend) and from 25.5% to 28% (P < 0.0001 for trend). HIV infection was associated with lower odds of shortterm survival following in-hospital CPR (adjusted odds ratio (aOR): 0.50, 95% confidence interval (95% CI): 0.39 -0.65). Select comorbid conditions (congestive heart failure, aOR: 2.03, 95% CI: 1.20 -2.46; cerebrovascular disease, aOR: 2.08, 95% CI: 1.15 -3.75; and diabetes, aOR: 1.53, 95% CI 1.31 -4.71) were the only independent predictors of short-term survival following in-hospital CPR among HIV hospitalizations. Conclusions:The rates of in-hospital CPR were similar among hospitalizations with and without HIV infection, with similar level of selectivity among decedents. Although HIV infection was associated with lower short-term survival following in-hospital CPR for the whole cohort, a dramatic improvement was observed during the study period among affected patients, with short-term survival rates becoming near-similar to those without HIV. Further studies are needed to identify modifiable factors to further improve the outcomes following in-hospital CPR among patients with HIV infection.

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“…In 2009, the rate of hospitalizations in the United States was estimated as 26.6 per 100 PLWH . Studies have reported a decline in hospitalizations in this population with most admissions attributed to non‐acquired immunodeficiency syndrome (AIDS)‐defining conditions …”

Section: Introductionmentioning

confidence: 99%

Evaluation of human immunodeficiency virus medication errors in a community hospital following the implementation of a pharmacist‐led antiretroviral stewardship program

Bunn

Hester²,

Maldonado

et al. 2019

J Am Coll Clin Pharm

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Introduction: Combination antiretroviral therapy has greatly improved survivability in people living with human immunodeficiency virus (PLWH); however, medicationrelated problems can attenuate virologic suppression and lead to therapeutic failure and drug resistance. The prevalence of antiretroviral (ARV) medication errors in hospitalized PLWH is highly variable, but it is clear that the potential for errors increases with the transition to inpatient care. Pharmacist-led ARV stewardship programs in large, academic institutions have demonstrated reductions in ARV errors during hospitalizations, but the feasibility of such programs in smaller, community hospitals in the Deep South remains unclear. Methods: We conducted a retrospective quasi-experimental study of non-pregnant, adult PLWH admitted to a community hospital between 2014 and 2018. The primary objective was to compare the percentage of admissions associated with a composite of ARV medication errors (inappropriate regimens, inaccurate dosing, delayed dosing, and major drug-drug interactions [DDIs]) before and after implementation of an ARV stewardship program. Results: The percentage of admissions associated with the primary composite of ARV medication errors decreased by 70% between the pre-intervention (56 [70%] of 80 admissions) and post-intervention period (13 [21.3%] of 61 admissions). The percentage of admissions associated with inappropriate ART regimens, major DDIs, and multiple ARV errors all decreased by more than 80%. There was no significant difference in the percentage of admissions associated with renal, non-renal, or delayed dosing errors despite an overall decrease in error frequency. Discussion: A significant reduction in ARV medication error rates comparable to those reported in similar studies conducted at large, academic institutions was observed. The impact of this innovative pharmacist-led ARV stewardship program provides additional evidence of the effectiveness of such programs in community hospitals with modest personnel resources. K E Y W O R D S

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Hospitalization Rates Among People With HIV/AIDS in New York City, 2013

Cited by 32 publications

References 20 publications

Platelets in Immune Response to Virus and Immunopathology of Viral Infections

Platelets in Immune Response to Virus and Immunopathology of Viral Infections

In-Hospital Cardiopulmonary Resuscitation of Patients With Human Immunodeficiency Virus Infection: A Population-Based Cohort Study of Epidemiology and Outcomes

Evaluation of human immunodeficiency virus medication errors in a community hospital following the implementation of a pharmacist‐led antiretroviral stewardship program

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