HIV-related morbidity in the HAART era

Abstract number: 1733_1394

Escobar M.A., Garcia-Egido A.A., Romero S.P., Bernal J.A., Puerto J.L., Gonzalez-Outon J., Asencio C., Gomez F.

AIDS related hospital admissions and morbidity have decreased after the introduction of HAART.

Objective: To assess the changes in hospital admissions and morbidity with the improvement of HARRT.

Methods: We studied the hospital admissions and morbidity over three different periods pre-HAART (January 1992 to December 1994), early-HAART (January 1995 to December 1998) and post-HAART (January 1999 to October 2004), in HIV infected patients followed at our centre.

Results are expressed for periods pre-HAART, early HAART, and post-HAART respectively. Mean (SD) CD4/mL were: 16±5, 37±11 and 118±33 (p < 0.0001). Undetectable plasma viral load (%) were: 0, 16 and 43 (p < 0.0001). Patients with a prior diagnosis of AIDS were: 91%, 68% and 36% (p < 0.001). The rate (%) of women/heterosexuals was: 6/2, 11/5 and 21/11 (p < 0.01) and, that of IVDA (%) was: 96, 88 and 75 (p = 0.03). Hospital admissions due to AIDS-defining illnesses decreased (p < 0.001) with a significant increase in the rate of respiratory tract infections (p < 0.005), digestive tract (p < 0.01) and liver diseases (p < 0.001). The proportion of AIDS-defining illnesses decreased after HAART (p < 0.01), whereas the rate of liver diseases increased (p < 0.001).

Conclusions: The HAART era has been associated with a progressive decrease in hospital admissions due to AIDS-defining conditions, and a steady enhancement of the spectrum of admissions by non-AIDS-defining conditions has increased.