Profile of HIV Inpatients, Mortality Rate and Associated Factors in the Era of Antiretroviral Therapy at an Urban Hospital in Burkina Faso

Abstract

Background: HIV infection remains a public health concern mainly in infectious diseases department despite the availability of diagnosis and antiretroviral therapy. Our objectives were to describe the clinical and biological profiles of HIV inpatients and to determine mortality rate and associated factors in infectious diseases department among these patients. Method: Retrospective cross-sectional study using medical records from January, the 1rst 2011 to December, the 31th 2015 is conducted at an urban teaching hospital in Burkina Faso (Bobo-Dioulasso town). The study included patients over 15 years tested HIV-positive and hospitalized in the department of infectious diseases during the period of the study. Usual statistic was performing to describe study population and logistic regression to identify factors associated with death. Result: A total of 730 medical records were included of which 440 inpatients were women with a sex-ratio of 0.6.Their average age were 40.3± 10.7 years-old. The three and four clinical stages according to the World health organization (WHO) classification were dominant with 37.1% and 56.9% respectively.The average of CD4 cell counts was 133.96 cell/µL and 79% of patients had less than 200 CD4 cell/µL. The main diagnoses were: tuberculosis (20.7%), gastroenteritis (19.3%) and bacterial pneumonia (15.7%). Before hospitalization, 40.9% of the patients were treated with antiretroviral therapy. The ARV treatment was started during hospitalization for 8% of the HIV infected patients without ARV treatment at entry, and for 2.8% of patient’s detected HIV positive during the hospitalization. The overall mortality rate was 33.4%. By multivariate analysis, the factors associated to death in the study period were: general state at the input, age group, duration of hospitalization and presence of secondary diagnosis. Conclusion: HIV-related infections are the main causes of hospitalization in our service. The mortality rate among HIV inpatients stayed high. Improvements of HIV inpatients health care management would be needed.