Browsing by Author "Rutagwera D"

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    Care Continuum and Postdischarge Outcomes Among HIV-Infected Adults Admitted to the Hospital in Zambia.
    (2019-Oct) Haachambwa L; Kandiwo N; Zulu PM; Rutagwera D; Geng E; Holmes CB; Sinkala E; Claassen CW; Mugavero MJ; Wa Mwanza M; Turan JM; Vinikoor MJ; Zambia National Public Health Institute, Lusaka, Zambia.; Center for Global Health and Quality, Georgetown University School of Medicine, Washington, District of Columbia.; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.; University Teaching Hospital HIV AIDS Programme, Lusaka, Zambia.; Johns Hopkins University, Baltimore, Maryland.; School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.; School of Medicine, University of Zambia, Lusaka, Zambia.; Department of Medicine, University of California at San Francisco, San Francisco, California.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; Department of Medicine, University Teaching Hospital, Lusaka, Zambia.; School of Medicine, University of Maryland at Baltimore, Baltimore, Maryland.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    BACKGROUND: We characterized the extent of antiretroviral therapy (ART) experience and postdischarge mortality among hospitalized HIV-infected adults in Zambia. METHODS: At a central hospital with an opt-out HIV testing program, we enrolled HIV-infected adults (18+ years) admitted to internal medicine using a population-based sampling frame. Critically ill patients were excluded. Participants underwent a questionnaire regarding their HIV care history and CD4 count and viral load (VL) testing. We followed participants to 3 months after discharge. We analyzed prior awareness of HIV-positive status, antiretroviral therapy (ART) use, and VL suppression (VS; <1000 copies/mL). Using Cox proportional hazards regression, we assessed risk factors for mortality. RESULTS: Among 1283 adults, HIV status was available for 1132 (88.2%), and 762 (67.3%) were HIV-positive. In the 239 who enrolled, the median age was 36 years, 59.7% were women, and the median CD4 count was 183 cells/mm CONCLUSIONS: Most HIV-related hospitalizations and deaths may now occur among ART-experienced vs -naïve individuals in Zambia. Development and evaluation of inpatient interventions are needed to mitigate the high risk of death in the postdischarge period.