Mortality from Infections Associated with Health Care in Patients with HIV in Paraguay

Gladys Lopez; Gloria Aguilar; Carlos Miguel Rios-González

doi:10.52379/mcs.v8i2.369

Authors

Gladys Lopez ,
Gloria González , https://orcid.org/0000-0001-8341-701X
Carlos Miguel Rios-González , Facultad de Ciencias Médicas, Universidad Nacional de Caaguazú, Cnel. Oviedo – Paraguay. https://orcid.org/0000-0001-7558-8206

Keywords:

Array, Array, Array

Abstract

Introduction: Few studies have evaluated HAIs in an HIV population; however, studies have suggested that patients with HIV are at a higher risk of contracting HAI because they have high rates of hospitalization and longer hospital stays. Objective: To determine mortality due to Infections Associated with Health Care in Patients with HIV in Paraguay from January to December 2018 to 2021. Methodology: This was an observational, descriptive, and cross-sectional study. The study population consisted of people over 18 years of age who died with a diagnosis of HIV infection and IAAS of both sexes during that period. The study variables were demographic, HIV-related, Baseline Viral Load, Stage of HIV infection at the time of diagnosis, Time from HIV diagnosis to death (in months), comorbidities at the time of death, microorganism isolation, presence, and location. of IAAS. Results: 93 patients with IAAS were included in the study, of which 34.4% (32) were between 20 and 29 years of age and 19.3% (18). Regarding the type of population, 79.3% (73) were in the general population, 77.6% (59) were diagnosed with AIDS, and 68.6% (59) had a baseline CD4 count of less than 200 cells/mm3. The mortality rate in 2020 was 6.7%, during 2018 it was 6.5% and in 2021 it and 6.4%. Conclusion: People with HIV, especially those who have been diagnosed in advanced stages of the disease, are more likely to develop HAIs and are related to mortality. This is due to the presence of multiple opportunistic infections and comorbidities that favor a high number of hospitalizations and longer hospital stays.

Downloads

Download data is not yet available.

References

Ríos-González CM. Reflexiones sobre el VIH y la salud fronteriza. Rev. virtual Soc. Parag. Med. Int. 2023;10(2): 151-153. https://doi.org/10.18004/rvspmi/2312-3893/2023.10.02.151.

Ministerio de Salud Publica y Bienestar Social. Situación Epidemiologica del VIH en Paraguay. Disponible en: https://www.mspbs.gov.py/dependencias/pronasida/adjunto/252034-INFORMEEPIDEMIOLOGICOVIH2022.pdf

Haque M, Sartelli M, McKimm J, Abu Bakar M. Health care-associated infections - an overview. Infect Drug Resist. 2018;11:2321-2333. https://doi.org/10.2147/idr.s177247.

Mitha M, Furuya EY, Larson E. Risk of healthcare associated infections in HIV positive patients. J Infect Prev. 2014;15(6):214-220. https://doi.org/10.1177/1757177414548694.

Reis Danielle Saraiva Tuma dos, Carneiro Irna Carla do Rosário Souza, Neves Dilma Costa de Oliveira, Marsola Lourival Rodrigues, Sousa Rita Catarina Medeiros. Healthcare-associated infections among HIV-positive and HIV/AIDS-negative patients: a casuistic from the Amazonian Region. Rev Pan-Amaz Saude. 2013;4(2):27-32. http://dx.doi.org/10.5123/S2176-62232013000200004.

Castro-Lima VAC, Borges IC, Joelsons D, Sales VVT, Guimaraes T, Ho YL, Costa SF, Moura MLN. Impact of human immunodeficiency virus infection on mortality of patients who acquired healthcare associated infection in critical care unit. Medicine (Baltimore). 2019;98(23):e15801. https://doi.org/10.1097/md.0000000000015801.

Rojas D, Wendell D, Ferguson PhD TF, Robinson WT, Trepka MJ, Straif-Bourgeois SC. HIV-associated comorbidities as mediators of the association between people living with HIV and hospital-acquired infections. Am J Infect Control. 2019;47(12):1500-1504. https://doi.org/10.1016/j.ajic.2019.05.028. Epub 2019 Jul 16.

Zalmanovich A, Ben-Ami R, Rahav G, Alon D, Moses A, Olshtain-Pops K, Weinberger M, Shitrit P, Katzir M, Gottesman BS, Chowers M. Healthcare-associated Pneumocystis jirovecii Pneumonia (PJP) Infection in HIV-negative Adults: a Multicenter Study. Isr Med Assoc J. 2021;23(5):312-317. URL.

Nasiri N, Sharifi A, Ghasemzadeh I, Khalili M, Karamoozian A, Khalooei A, Beigzadeh A, Haghdoost A, Sharifi H. Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran. BMC Infect Dis. 2023;23(1):171. https://doi.org/10.1186/s12879-023-08122-1.

Ganczak M, Barss P. Nosocomial HIV infection: epidemiology and prevention--a global perspective. AIDS Rev. 2008;10(1):47-61.

Ertunc B, Kaya S, Koksal I. Clinico-Epidemiological Analysis of HIV/AIDS Patients. Eurasian J Med. 2016;48(3):157-161. https://doi.org/10.5152/eurasianjmed.2016.15203.

Hu X, Liang B, Zhou C, Jiang J, Huang J, Ning C, Liu J, Zhou B, Zang N, Lai J, Chen R, Liao Y, Pan P, Liu X, Lan G, Pang X, Ye L, Shen Z, Liang H. HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study. AIDS Res Ther. 2019;16(1):6. https://doi.org/10.1186/s12981-019-0221-7.

Khan MA, Sehgal A. Clinico-epidemiological and Socio-behavioral Study of People Living with HIV/AIDS. Indian J Psychol Med. 2010;32(1):22-8. https://doi.org/10.4103/0253-7176.70523.

Balasundaram A, Sarkar S, Hamide A, Lakshminarayanan S. Socioepidemiologic profile and treatment-seeking behaviour of HIV/AIDS patients in a tertiary-care hospital in south India. J Health Popul Nutr. 2014;32(4):587-94.

Gao D, Zou Z, Dong B, Zhang W, Chen T, Cui W, Ma Y. Secular trends in HIV/AIDS mortality in China from 1990 to 2016: Gender disparities. PLoS One. 2019;14(7):e0219689. https://doi.org/10.1371/journal.pone.0219689.

GBD 2015 Mortality and Causes of Death Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1459-1544. https://doi.org/10.1016/s0140-6736(16)31012-1

Deng P, Chen M, Si L. Temporal trends in inequalities of the burden of HIV/AIDS across 186 countries and territories. BMC Public Health. 2023;23(1):981. https://doi.org/10.1186/s12889-023-15873-8.

Sydnor ER, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clin Microbiol Rev. 2011;24(1):141-73. https://doi.org/10.1128/cmr.00027-10.

Owusu AY. Experiences of new diagnoses among HIV-positive persons: implications for public health. BMC Public Health. 2022;22(1):538. https://doi.org/10.1186/s12889-022-12809-6.

Tchakoute CT, Liu J, Cohen B, Larson E. Risk Factors and Temporal Trends of Hospital-Acquired Infections (HAIs) Among HIV Positive Patients in Urban New York City Hospitals: 2006 to 2014. Rev Recent Clin Trials. 2017;12(1):44-50. https://doi.org/10.2174/1574887111666160906094140.