Search

Objectives: Annual screening for gonorrhea [Neisseria gonorrhoeae (NG)] and chlamydia [Chlamydia trachomatis (CT)] is recommended for all sexually active persons living with HIV but is poorly implemented. Studies demonstrating no increases in NG and/or CT (NG/CT) case detection in clinics that successfully expanded NG/CT screening raise questions about this broad screening approach. We evaluated NG/CT case detection in the HIV Research Network during 2004–2014, a period of expanding testing. Methods: We analyzed linear time trends in annual testing (patients tested divided by all patients in care), test positivity (patients positive divided by all tested), and case detection (the number of patients with a positive result divided by all patients in care) using multivariate repeated measures logistic regression. We determined trends overall and stratified by men who have sex with men (MSM), men who have sex exclusively with women, and women. Results: Among 15,614 patients (50% MSM, 26% men who have sex exclusively with women, and 24% women), annual NG/CT testing increased from 22% in 2004 to 60% in 2014 [adjusted odds ratio (AOR) per year 1.22 (1.21–1.22)]. Despite the increase in testing, test positivity also increased [AOR per year 1.10 (1.07– 1.12)], and overall case detection increased from 0.8% in 2004 to 3.9% in 2014 [AOR per year 1.20 (1.17–1.22)]. Case detection was highest among MSM but increased over time among all 3 groups. Conclusions: NG/CT case detection increased as testing expanded in the population. This supports a broad approach to NG/CT screening among persons living with HIV to decrease transmission and complications of NG/CT and of HIV. [ABSTRACT FROM AUTHOR]

Chronic viral hepatitis is a potentially important determinant of health care utilization among persons living with HIV. We describe hospitalization rates and reasons for hospitalization among persons living with HIV stratified by coinfection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV).Laboratory, demographic, and hospitalization data were obtained for all patients receiving longitudinal HIV care during 2010 at 9 geographically diverse sites. Hepatitis serostatus was assessed by hepatitis B surface antigen and/or hepatitis C antibody. ICD-9 codes were used to assign hospitalizations into diagnostic categories. Negative binomial regression was used to assess factors associated with all-cause and diagnostic category-specific hospitalizations.A total of 2793 hospitalizations were observed among 12,819 patients. Of these patients, 49.3% had HIV monoinfection, 4.1% HIV/HBV, 15.4% HIV/HCV, 2.5% HIV/HBV/HCV, and 28.7% unknown hepatitis serostatus. Compared with HIV monoinfection, the risk of all-cause hospitalization was increased with HIV/HBV [adjusted incidence rate ratio 1.55 (1.17 to 2.06)], HIV/HCV [1.45 (1.21 to 1.74)], and HIV/HBV/HCV [1.52 (1.04 to 2.22)]. Risk of hospitalization for non-AIDS-defining infection was also higher among patients with HIV/HBV [2.07 (1.38 to 3.11)], HIV/HCV [1.81 (1.36 to 2.40)], and HIV/HBV/HCV [1.96 (1.11 to 3.46)]. HIV/HBV was associated with hospitalization for gastrointestinal/liver disease [2.55 (1.30 to 5.01)]. HIV/HCV was associated with hospitalization for psychiatric illness [1.89 (1.11 to 3.26)].HBV and HCV coinfection are associated with increased risk of all-cause hospitalization and hospitalization for non-AIDS-defining infections, as compared with HIV monoinfection. Policy-makers and third-party payers should be aware of the heightened risk of hospitalization associated with coinfection when allocating health care resources and considering models of health care delivery. [ABSTRACT FROM AUTHOR]

The article investigates the prevalence of established risk factors for venous thromboembolism (VTE) in HIV-infected patients, and explores novel risk factors. It shows that the incidence of VTE in the cohort is similar to that reported in other cohorts of patients with HIV. The article provides evidence that recent hospitalization is the risk factor most strongly associated with VTE.

The article focuses on the hospitalizations for metabolic conditions, opportunistic infections and injection drug use among HIV patients in 72 states. Rapid changes in HIV epidemiology and highly active antiretroviral therapy (HAART) result in inpatient utilization. The objectives is to examine trends in inpatient diagnoses and mortality in HIV patients. Each hospitalization was classified as an opportunistic illness, complication of injection drug use, liver-related complication, and diabetes.

Cites a study about the incidence, risk factors and clinical sequelae of herpes zoster. Significance of the patients percentage with post-herpetic neuralgia on the zoster infection rates changes; Identification of patients with episode of herpes zoster; Assessment of factors associated with an initial episode of herpes zoster.

Examines demographic and clinical differences associated with receipt of highly active antiretroviral therapy (HAART) and the association of outpatient utilization with HAART. Redaction of persistent disparities in women; Evidence for racial and ethnic disparities in the receipt of antiretroviral therapy; Risk factors for HIV transmission.

Reports on recommended guidelines for consideration of CD4 cell percentage as well as CD4 cell count in therapeutic decisions for AIDS patients. Prediction of the risk of AIDS-defining illnesses (ADI); Assessment of the incidence of ADI ; Computation of the incidence ratio rate with the use of multivariable negative binomial regression.

Reports on a retrospective cohort study performed using data from U.S. managed care plans from 1997 to 2002 to examine the epidemiology, treatment patterns and costs of cytomegalovirus (CMV) retinitis treatment in the post-highly active antiretroviral therapy (HAART) era. Definition of cases of CMV retinitis by requiring diagnosis codes for HIV or AIDS, CMV and retinitis and claims for anti-CMV treatment; Examination of costs of oral, intravenous and intraocular treatment periods.

Studies whether hepatitis C virus infection status affected hospitalization rates, intensive care utilization and discharge diagnoses between 1995 and 2000 in patients with HIV. Reduction of mortality and morbidity in HIV infected patients through highly active antiretroviral therapy.

Evaluates the hospitalization rates and patterns in discharge diagnosis among HIV-positive patients in the United States between 1995 and 1998. Risk factors for hospitalization; Characteristics of the study population; Impact of the introduction of highly active antiretroviral therapy on the rate of hospitalization.