Highly Active Drugs Cut Hospital Days for HIV/AIDS Patients

"Highly Active" Drugs Cut Hospital Days for HIV/AIDS Patients

Contact:Kevin AndererLippincott Williams & Wilkins530 Walnut StreetPhiladelphia, PA 19106Fax 215 521 8495

May 7, 2002 -- Data from a nationwide network of HIV clinics--published in the May issue of JAIDS: Journal of Acquired Immune Deficiency Syndromes--suggest that current highly active antiretroviral therapy (HAART) has reduced the amount of time HIV-positive patients spend in the hospital.

The report by The HIV Research Network includes data on 5,255 patients treated at nine American HIV primary and specialty care clinics during 1999. Seventeen percent of the patients were hospitalized sometime during the year, for an average of 297 hospital days per 100 patients.

For patients receiving HAART, hospital time averaged 265 days per 100 patients, compared with 320 days per 100 patients for those not receiving this type of combination drug therapy. In contrast, patients receiving HAART made more clinic visits for outpatient care.

Hospital time was even more strongly affected by the CD4 cell count, an indicator of immune system function. Hospital days averaged 165 per 100 patients with a CD4 cell count of more than 500 cells per square millimeter (mm"), compared to 840 days per 100 patients with a CD4 count of less than 50 per mm.

Clinic visits also increased at lower CD4 counts. Hospital days and clinic visits were also affected by HIV RNA level, an indicator of the severity of HIV infection.

Other factors affecting patterns of HIV care included race, with African-American patients spending more time in the hospital than white patients while making fewer clinic visits; and gender, with women making more clinic visits than men.

Monthly health care spending per patient averaged $423 for hospital care and $168 for outpatient care. Compared with previous studies, these figures suggest that the costs of HIV care may have leveled off since the advent of HAART in the late 1990s. However, data from the past few years will be needed to confirm this conclusion.

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The HIV Research Network (Participating sites, sponsoring agencies, and participants are listed in the article appendix online at jaids.com.) Hospital and Outpatient Health Services Utilization Among HIV-Infected Patients in Care in 1999. JAIDS: Journal of Acquired Immune Deficiency Syndromes Volume 30 Number 1, 2002. FULL TEXT ONLINE AT JAIDS.COM