Profile of presentation of HIV-positive patients to an emergency department in Johannesburg, South Africa.

IF 1.6 4区医学 Q4 INFECTIOUS DISEASES

Southern African Journal of Hiv Medicine Pub Date : 2021-01-29 eCollection Date: 2021-01-01 DOI:10.4102/sajhivmed.v22i1.1177

Abdullah E Laher, Willem D F Venter, Guy A Richards, Fathima Paruk

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引用次数: 10

Abstract

Background: Despite improved availability and better access to antiretroviral therapy (ART), approximately 36% of human immunodeficiency virus (HIV)-positive South Africans are still not virally suppressed.

Objective: The aim of this study was to describe the patterns of presentation of HIV-positive patients to a major central hospital emergency department (ED).

Methods: In this prospectively designed study, consecutive HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) adult ED were enrolled between 07 July 2017 and 18 October 2018.

Results: A total of 1224 participants were enrolled. Human immunodeficiency virus was newly diagnosed in 212 (17.3%) patients, 761 (75.2%) were on ART, 245 (32.2%) reported ART non-adherence, 276 (22.5%) had bacterial pneumonia, 244 (19.9%) had tuberculosis (TB), 86 (7.0%) had gastroenteritis, 205 (16.7%) required intensive care unit admission, 381 (31.1%) were admitted for ≥ 7 days and 166 (13.6%) died. With regard to laboratory parameters, CD₄ cell count was < 100 cell/mm³ in 527 (47.6%) patients, the viral load (VL) was > 1000 copies/mL in 619 (59.0%), haemoglobin was < 11 g/dL in 636 (56.3%), creatinine was > 120 µmol/L in 294 (29.3%), lactate was > 2 mmol/L in 470 (42.0%) and albumin was < 35 g/L in 633 (60.8%).

Conclusion: Human immunodeficiency virus-positive patients presenting to the CMJAH ED demonstrated a high prevalence of opportunistic infections, required a prolonged hospital stay and had high mortality rates. There is a need to improve the quality of ART services and accessibility to care.

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南非约翰内斯堡一家急诊科的艾滋病毒阳性患者介绍。

背景:尽管抗逆转录病毒治疗(ART)的可得性和可及性有所提高，但南非仍有大约36%的人类免疫缺陷病毒(HIV)阳性患者没有得到病毒抑制。目的:本研究的目的是描述hiv阳性患者在主要中心医院急诊科(ED)的表现模式。方法:在这项前瞻性设计的研究中，在2017年7月7日至2018年10月18日期间，连续入组到夏洛特·马克西克约翰内斯堡学术医院(CMJAH)成人急诊科就诊的hiv阳性患者。结果:共纳入1224名受试者。新诊断人类免疫缺陷病毒212例(17.3%)，接受抗逆转录病毒治疗761例(75.2%)，抗逆转录病毒治疗不依从245例(32.2%)，细菌性肺炎276例(22.5%)，结核病244例(19.9%)，肠胃炎86例(7.0%)，需要入住重症监护病房205例(16.7%)，住院≥7天381例(31.1%)，死亡166例(13.6%)。实验室参数方面，CD4细胞计数< 100细胞/mm3的527例(47.6%)，病毒载量(VL) > 1000拷贝/mL的619例(59.0%)，血红蛋白< 11 g/dL的636例(56.3%)，肌酐> 120µmol/L的294例(29.3%)，乳酸> 2 mmol/L的470例(42.0%)，白蛋白< 35 g/L的633例(60.8%)。结论:出现CMJAH ED的人类免疫缺陷病毒阳性患者表现出机会性感染的高患病率，需要延长住院时间，死亡率高。有必要提高抗逆转录病毒治疗服务的质量和获得护理的机会。

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

Southern African Journal of Hiv Medicine 医学-病毒学

CiteScore

2.80

自引率

11.80%

发文量

审稿时长

>12 weeks

期刊介绍： The Southern African Journal of HIV Medicine is focused on HIV/AIDS treatment, prevention and related topics relevant to clinical and public health practice. The purpose of the journal is to disseminate original research results and to support high-level learning related to HIV Medicine. It publishes original research articles, editorials, case reports/case series, reviews of state-of-the-art clinical practice, and correspondence.