Care Continuum and Postdischarge Outcomes Among HIV-Infected Adults Admitted to the Hospital in Zambia.

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dc.contributor.affiliationZambia National Public Health Institute, Lusaka, Zambia.
dc.contributor.affiliationCenter for Global Health and Quality, Georgetown University School of Medicine, Washington, District of Columbia.
dc.contributor.affiliationDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
dc.contributor.affiliationUniversity Teaching Hospital HIV AIDS Programme, Lusaka, Zambia.
dc.contributor.affiliationJohns Hopkins University, Baltimore, Maryland.
dc.contributor.affiliationSchool of Public Health, University of Alabama at Birmingham, Birmingham, Alabama.
dc.contributor.affiliationSchool of Medicine, University of Zambia, Lusaka, Zambia.
dc.contributor.affiliationDepartment of Medicine, University of California at San Francisco, San Francisco, California.
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia, Lusaka, Zambia.
dc.contributor.affiliationDepartment of Medicine, University Teaching Hospital, Lusaka, Zambia.
dc.contributor.affiliationSchool of Medicine, University of Maryland at Baltimore, Baltimore, Maryland.
dc.contributor.affiliationCIDRZ
dc.contributor.affiliationCentre for Infectious Disease Research in Zambia (CIDRZ)
dc.contributor.authorHaachambwa L
dc.contributor.authorKandiwo N
dc.contributor.authorZulu PM
dc.contributor.authorRutagwera D
dc.contributor.authorGeng E
dc.contributor.authorHolmes CB
dc.contributor.authorSinkala E
dc.contributor.authorClaassen CW
dc.contributor.authorMugavero MJ
dc.contributor.authorWa Mwanza M
dc.contributor.authorTuran JM
dc.contributor.authorVinikoor MJ
dc.date.accessioned2025-05-23T11:41:16Z
dc.date.issued2019-Oct
dc.description.abstractBACKGROUND: 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.
dc.identifier.doi10.1093/ofid/ofz336
dc.identifier.urihttps://pubs.cidrz.org/handle/123456789/10443
dc.sourceOpen forum infectious diseases
dc.titleCare Continuum and Postdischarge Outcomes Among HIV-Infected Adults Admitted to the Hospital in Zambia.

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