RESUMEN
In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older (40.0 versus 36.5 years), reported injection drug use (58.3% versus 0%) and were hepatitis C virus co-infected (65.8% versus 0%) compared with females. Severe immunosuppression was prevalent (median CD4 count = 42 cell/µL). Candidiasis was the most common diagnosis (26.0%); Pneumocystis pneumonia was the most common respiratory disease (8.8%), while cerebral toxoplasmosis was diagnosed in 8.4% of patients. Current HAART use was independently associated with low risk of in-hospital mortality (OR 0.33), while central nervous system symptoms (OR 4.12), sepsis (OR 6.98) and low total lymphocyte counts (OR 3.60) were associated with increased risk. In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality.
Asunto(s)
Infecciones por VIH/mortalidad , Mortalidad Hospitalaria , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Síndrome de Inmunodeficiencia Adquirida/tratamiento farmacológico , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Adulto , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Coinfección/mortalidad , Femenino , Infecciones por VIH/tratamiento farmacológico , Hepatitis C/mortalidad , Humanos , Libia/epidemiología , Masculino , Prevalencia , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Trastornos Relacionados con Sustancias/mortalidadRESUMEN
In Libya, little is known about HIV-related hospitalizations and in-hospital mortality. This was a retrospective analysis of HIV-related hospitalizations at Tripoli Medical Centre in 2013. Of 227 cases analysed, 82.4% were males who were significantly older [40.0 versus 36.5 years], reported injection drug use [58.3% versus 0%] and were hepatitis C virus co-infected [65.8% versus 0%] compared with females. Severe immunosuppression was prevalent [median CD4 count = 42 cell/micro L]. Candidiasis was the most common diagnosis [26.0%]; Pneumocystis pneumonia was the most common respiratory disease [8.8%], while cerebral toxoplasmosis was diagnosed in 8.4% of patients.Current HAART use was independently associated with low risk of in-hospital mortality [OR 0.33], while central nervous system symptoms [OR 4.12], sepsis [OR 6.98]and low total lymphocyte counts [OR 3.60]were associated with increased risk.In this study, late presentation with severe immunosuppression was common, and was associated with significant in-hospital mortality
En Libye, les connaissances sur les hospitalisations et la mortalite en milieu hospitalier liees au VIH sont rares. Nous avons procede a une analyse retrospective des hospitalisations liees au VIH au centre medical de Tripoli en 2013. Sur 227 cas analyses,82,4 % etaient des hommes nettement plus ages [40,0 contre 36,5 ans], qui declaraient s'injecter des drogues [58,3 % contre 0 %]et qui etaient atteints d'une co-infection par le virus de l'hepatite C [65,8 % contre 0 %] comparativement aux femmes.L'immunosuppression severe etait prevalente [numeration des lymphocytes T-CD4 = 42 cellules/micro L]. Le diagnostic le plus frequent etait la candidose [26,0 %]; la pneumonie a Pneumocystis etait la maladie respiratoire la plus frequente [8,8 %], tandis que la toxoplasmose cerebrale etait diagnostiquee chez 8,4 % des patients]. Un traitement antiretroviral hautement actif en cours etait independamment associe a un faible risque de mortalite en milieu hospitalier [OR 0,33], tandis que les symptomes du systeme nerveux central [OR 4,12], la septicemie [OR 6,98] et les faibles numerations lymphocytaires totales [OR 3,60] etaient associes a un risqué accru.Dans cette etude,une presentation tardive accompagnee d'une immunosuppression severe etait frequente,et etait associee a une mortalite elevee en milieu hospitalier