Hospitalizations Among HIV-Positive Infants, Young Children in U.S. Decreasing Because of HAART, Study Says
Hospitalizations among HIV-positive infants and children younger than age five are decreasing because of the introduction and widespread use of highly active antiretroviral therapy, according to a study published in the August issue of Pediatrics, Reuters Health reports. Athena Kourtis of CDC and colleagues used the National Inpatient Sample database to examine trends in hospital visits among HIV-positive children and adolescents during the 10 years between 1994, before HAART was introduced, and 2003, after HAART was in widespread use. The researchers found that there were an estimated 3,420 hospitalizations among HIV-positive children ages 18 or younger in 2003, compared with 11,785 in 1994 -- a decrease of 71%.
The decrease in hospitalizations was more apparent among infants and preschool-aged children, as the researchers recorded a 94% decrease among boys and a 92% decrease among girls in this age group, according to Reuters Health. The researchers recorded a 47% decrease in hospitalizations among boys ages 15 to 18 and an increase of 23% among girls in this age group. The inpatient fatality rates among HIV-positive children also decreased from 5% in 1994 to 1.8% in 2003, according to the study.
In addition, the researchers found that hospitalizations for several HIV-associated conditions became less common after HAART was introduced and came into widespread use. These conditions include bacterial pneumonia caused by Pneumocystis jiroveci, general bacterial infections, sepsis, systemic infections, fungal infections, brain infections and failure to thrive. The researchers did not observe any significant changes in the number of hospitalizations for Pneumococcus or cytomegalorvirus infections.
The researchers wrote that they hope the study's findings will be used to examine the health needs of specific HIV-positive populations, including adolescents, as well as specific HIV-associated complications. They said that they also hope the study will help "define future policies in an era of competing health care priorities" (Reuters Health, 8/29).
The study is available online.