HIV disease hospitalizations and factors associated with in-hospital mortality in Ecuador: A nationwide analysis from 2015 to 2023.

IF 2.8 3区医学 Q2 INFECTIOUS DISEASES

HIV Medicine Pub Date : 2025-05-04 DOI:10.1111/hiv.70040

German Josuet Lapo-Talledo, Ángel Luis Zamora Cevallos, Carlos Rafael Arteaga Reyes, José Daniel Sánchez Redrobán, Jhon Ernesto Delgado Pinargote, Ángela María Espinoza Guevara, Edgar Antonio Menéndez Cuadros

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引用次数: 0

Abstract

Objective: Human immunodeficiency virus (HIV) remains a significant public health concern worldwide, contributing to notable rates of hospitalization and mortality. This study aimed to analyse HIV disease hospitalization trends and factors associated with in-hospital mortality in Ecuador during 2015-2023.

Methods: Official national hospital discharge data were used. Hospitalization and in-hospital mortality rates were calculated. Multivariable logistic regression was performed to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify factors associated with in-hospital mortality.

Results: Totally 28 408 HIV disease hospitalizations were analysed; the majority were males 61.19% (n = 17 383). Average hospitalization rate was 18.48 per 100 000 inhabitants. In-hospital deaths accounted for 11.31% (n = 3214). Older age (≥40 years) was significantly associated with a higher likelihood of death, particularly in 60-69 years (aOR 1.78, 95% CI 1.49-2.13) and ≥70 years (aOR 1.79, 95% CI 1.36-2.34). Patients with HIV-related Pneumocystis jirovecii pneumonia (aOR 2.74, 95% CI 2.28-3.29) and multiple malignant neoplasms (aOR 4.30, 95% CI 1.66-11.15) had the highest mortality likelihood. Although a declining trend in mortality rates was observed throughout 2015-2023, there was an increase in mortality probabilities in 2021 which may be linked to healthcare disruptions during the COVID-19 pandemic, while subsequent decline in 2022 and 2023 suggests improvements in HIV care access.

Conclusions: While HIV-related hospitalizations and mortality have declined in Ecuador, older patients and those with severe opportunistic infections or malignancies remain at higher risk. These findings underscore the need for early diagnosis, enhanced management of HIV-related complications and sustained antiretroviral therapy (ART) coverage, particularly during public health crises.

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厄瓜多尔艾滋病毒住院和与住院死亡率相关的因素：2015年至2023年的全国分析

目的：人类免疫缺陷病毒（艾滋病毒）仍然是世界范围内一个重大的公共卫生问题，造成了显著的住院率和死亡率。本研究旨在分析2015-2023年厄瓜多尔艾滋病住院趋势和与住院死亡率相关的因素。方法：采用国家官方医院出院数据。计算住院和住院死亡率。采用多变量logistic回归获得校正优势比（aORs）和95%置信区间（CIs），以确定与院内死亡率相关的因素。结果：共分析28408例艾滋病住院病例；男性居多，占61.19% （n = 17 383）。平均住院率为每10万居民18.48人。院内死亡占11.31% （n = 3214）。年龄较大（≥40岁）与较高的死亡可能性显著相关，特别是60-69岁（aOR 1.78, 95% CI 1.49-2.13）和≥70岁（aOR 1.79, 95% CI 1.36-2.34）。hiv相关性肺囊虫肺炎（aOR 2.74, 95% CI 2.28-3.29）和多发性恶性肿瘤（aOR 4.30, 95% CI 1.66-11.15）患者的死亡可能性最高。尽管2015-2023年期间死亡率呈下降趋势，但2021年的死亡率有所上升，这可能与2019冠状病毒病大流行期间的医疗中断有关，而随后在2022年和2023年的下降表明艾滋病毒护理的可及性有所改善。结论：虽然厄瓜多尔与艾滋病毒相关的住院率和死亡率有所下降，但老年患者和严重机会性感染或恶性肿瘤患者的风险仍然较高。这些发现强调了早期诊断、加强对艾滋病毒相关并发症的管理和持续抗逆转录病毒治疗（ART）覆盖的必要性，特别是在公共卫生危机期间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

HIV Medicine 医学-传染病学

CiteScore

5.10

自引率

10.00%

发文量

167

审稿时长

6-12 weeks

期刊介绍： HIV Medicine aims to provide an alternative outlet for publication of international research papers in the field of HIV Medicine, embracing clinical, pharmocological, epidemiological, ethical, preclinical and in vitro studies. In addition, the journal will commission reviews and other feature articles. It will focus on evidence-based medicine as the mainstay of successful management of HIV and AIDS. The journal is specifically aimed at researchers and clinicians with responsibility for treating HIV seropositive patients.