Trends in Hospitalizations of HIV-Infected Children and Adolescents in the United States: Analysis of Data From the 1994-2003 Nationwide Inpatient Sample
August 20, 2007
The researchers sought to describe trends in hospital use by HIV-infected US children and adolescents in the 10 years from 1994 (before highly active antiretroviral therapy) to 2003 (widespread use of HAART).
Using data from the Nationwide Inpatient Sample database, the scientists evaluated most frequent diagnoses by year, and trends in hospitalizations for selected diagnoses and procedures were examined by multivariate logistic regression.
An estimated 3,419 HIV-infected children under age 18 were hospitalized in 2003, compared with 11,785 in 1994 (a 71 percent drop). This decrease was more marked among infants and children under age 5 (94 percent for boys and 92 percent for girls) than among adolescents ages 15-18 (decrease of 47 percent for boys and an increase of 23 percent for girls). The inpatient fatality rate declined from 5.0 percent in 1994 to 1.8 percent in 2003. The number of hospitalizations among HIV-infected children in the HAART era decreased significantly compared with before HAART (1994-1996) for Pneumocystis jiroveci, bacterial infection, or sepsis; fungal infection; encephalopathy; failure to thrive; and lymphocytic interstitial pneumonia. A significant change in the number of hospitalizations for Pneumococcus or cytomegalovirus was not observed.
"Dramatic decreases in the number of hospitalizations among HIV-infected children occurred since the advent of [HAART] in the United States. However, this trend is not seen in hospitalizations of adolescents, particularly girls. Hospitalizations for several HIV-related conditions are less frequent in the [HAART] era, but for certain other conditions, the hospitalization burden remains high," the researchers concluded.
8.2007; Vol. 120; No. 2: P. e236-e243; Athena P. Kourtis, MD, PhD, MPH; Pooja Bansil, MPH; Samuel F. Posner, PhD; Christopher Johnson, MS; Denise J. Jamieson, MD, MPH
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