Trends in HIV-related morbidity among patients admitted to a South Indian tertiary hospital between 1997 and 2003

Abstract

This paper describes trends in HIV-related morbidity among people living with HIV/AIDS (PLWHA) admitted to a tertiary hospital in Chennai, South India, between 1997 and 2003. Patients comprised HIV-infected men, women and children who had been admitted at least once to YR Gaitonde Centre for AIDS Research and Education (YRGCARE). A non-parametric trends analysis was conducted to observe trends in clinical and demographic parameters and diagnoses at admission over the seven-year period. Among clinical and demographic parameters, we identified a significantly increasing time trend in the use of antiretroviral therapy (p<0.001) and a significant decrease in the mean hemoglobin level (p=0.01). Among diagnoses at admission, we identified a decreasing time trend for admissions due to pulmonary tuberculosis (p<0.001) and increasing trends for admissions due to extra pulmonary tuberculosis (p<0.01), toxoplasmosis (p<0.01), Pneumocystis carinii pneumonia (p=0.02) and anemia (p<0.001). The results indicate a changing pattern among the clinical conditions requiring admission. With increasing proportions of patients initiating highly active antiretroviral therapy (HAART), it is probable that adverse events due to HAART will account for larger proportions of admissions in the years to come, as is being seen in the industrialized countries.

Acknowledgments

We would like to thank all the clinical staff of YRGCARE for their support in this study. We would also like to thank Dr Marie Diener-West and Dr Rosa Crum of the Epi/Biostat concentration program at the Johns Hopkins Bloomberg School of Public Health. We would also like to thank Dr Vishwas R. Gaitonde for his critical review of this manuscript. This paper was supported, in part, by a fellowship/grant from the Fogarty International Center/USNIH: Grant # 2 D 43 TW000010-17-AITRP.