What dictates hospital admission for people with HIV?

As the CD4 cell count decreases and the viral load increases, an HIV-positive person becomes increasingly susceptible to opportunistic infections that may result in admission to hospital. While the existing staging systems for people with AIDS rely on physiologic and diagnostic information, the decision to use hospital services or other medical resources has been shown to be influenced by social factors or measures of the patient¹s ability to function at certain levels at disability. Robert Hogg and colleagues studied 947 HIV-positive men and women to evaluate the demographic and clinical determinants of admission to hospital among HIV-positive men and women receiving antiretroviral therapy in British Columbia. The authors found that 17% of the participants were admitted to hospital during the study period (May 1, 1996 to March 31, 1997). Hospital admission was associated with being unemployed (82% of those admitted v. 58% of those not admitted), being an injection drug user (24% v. 17%), reporting a poor health status (46% v. 29%), and having a physician experienced in the management of HIV/AIDS (31% v. 24%). Examination of clinical determinants demonstrated that hospital admission was associated with a previous admission (72% v. 46%), a high viral load, a low CD4 count and an AIDS diagnosis. Determinants of hospital admission among HIV-positive people in British Columbia

- A.E. Weber, B. Yip, M.V. O'Shaughnessy, J.S.G. Montaner, R.S. Hogg