Journal article
Hospitalization Rates and Reasons Among HIV Elite Controllers and Persons With Medically Controlled HIV Infection
The Journal of infectious diseases, v 211(11), pp 1692-1702
01 Jun 2015
PMID: 25512624
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Elite controllers spontaneously suppress human immunodeficiency virus (HIV) viremia but also demonstrate chronic inflammation that may increase risk of comorbid conditions. We compared hospitalization rates and causes among elite controllers to those of immunologically intact persons with medically controlled HIV.
For adults in care at 11 sites from 2005 to 2011, person-years with CD4 T-cell counts ≥350 cells/mm(2) were categorized as medical control, elite control, low viremia, or high viremia. All-cause and diagnostic category-specific hospitalization rates were compared between groups using negative binomial regression.
We identified 149 elite controllers (0.4%) among 34 354 persons in care. Unadjusted hospitalization rates among the medical control, elite control, low-viremia, and high-viremia groups were 10.5, 23.3, 12.6, and 16.9 per 100 person-years, respectively. After adjustment for demographic and clinical factors, elite control was associated with higher rates of all-cause (adjusted incidence rate ratio, 1.77 [95% confidence interval, 1.21-2.60]), cardiovascular (3.19 [1.50-6.79]) and psychiatric (3.98 [1.54-10.28]) hospitalization than was medical control. Non-AIDS-defining infections were the most common reason for admission overall (24.1% of hospitalizations) but were rare among elite controllers (2.7%), in whom cardiovascular hospitalizations were most common (31.1%).
Elite controllers are hospitalized more frequently than persons with medically controlled HIV and cardiovascular hospitalizations are an important contributor.
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Details
- Title
- Hospitalization Rates and Reasons Among HIV Elite Controllers and Persons With Medically Controlled HIV Infection
- Creators
- Trevor A Crowell - Johns Hopkins UniversityKelly A Gebo - Johns Hopkins UniversityJoel N Blankson - Johns Hopkins UniversityP Todd Korthuis - Oregon Health & Science UniversityBaligh R Yehia - University of PennsylvaniaRichard M Rutstein - Drexel UniversityRichard D Moore - Johns Hopkins UniversityVictoria Sharp - St. Luke's-Roosevelt Hospital CenterAnk E Nijhawan - The University of Texas Southwestern Medical CenterW Christopher Mathews - University of California, San DiegoLawrence H Hanau - Yeshiva UniversityRoberto B Corales - Trillium Health CentreRobert Beil - Montefiore Medical CenterCharurut Somboonwit - Tampa General HospitalHoward Edelstein - Alameda County Medical CenterSara L Allen - Drexel UniversityStephen A Berry - Johns Hopkins UniversityHIV Research Network
- Publication Details
- The Journal of infectious diseases, v 211(11), pp 1692-1702
- Publisher
- Oxford University Press
- Grant note
- HHSA290201100007C / PHS HHS KL2TR001103 / NCATS NIH HHS P30 AI045008 / NIAID NIH HHS K23 AI084854 / NIAID NIH HHS HHSH250201200008C / PHS HHS KL2 TR001103 / NCATS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- [Retired Faculty]
- Web of Science ID
- WOS:000355675100002
- Scopus ID
- 2-s2.0-84930466480
- Other Identifier
- 991019167628704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Immunology
- Infectious Diseases
- Microbiology