Hospitalization of HIV Positive Patients in Different Countries – Reasons and Differences
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Date
2022
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Neskatoties uz to, ka HIV infekcija kā slimība ir zināma jau daudzus gadus un visā pasaulē ir zināms, kā samazināt HIV incidenci un letalitāti, stacionēto pacientu skaits vēl arvien ir liels, īpaši mazattīstītās valstīs. Pētījuma mērķis ir izveidot visaptverošu literatūras apskatu par HIV pozitīvu pacientu stacionēšanas iemesliem, salīdzinot Eiropas, Āfrikas, Ziemeļamerikas un Dienvidamerikas reģionus. Tika analizēti zinātniski raksti no dažādām valstīm un reģioniem (Eiropa, Āfrika, Ziemeļ- un Dienvidamerika). Tika noteikti sekojoši iekļaušanas un izslēgšanas kritēriji: pētījuma populācija ar ne mazāk100 pacientiem, publikācija ne vecāka par 2005.gadu un tā pieejama angļu valodā. Pētījumā tika iekļautas tikai minētajiem kritērijiem atbilstošas publikācijas un zinātniskie raksti, citas tika izslēgtas.Kopumā ņemot, Eiropas situācija ir ievērojami labāka salīdzinot ar citiem kontinentiem HIV inficēto pacientu hospitalizācijas jomā, taču jāņem vērā situācija atsevišķās valstīs, kā piemēram, Latvijā, kurā vēl arvien ir augsts HIV inficēto pacientu stacionēšanas īpatsvars, daudz jaunatklātu pacientu un augsts letālu iznākumu skaits. Analizējot lielu publikāciju skaitu, korelācija starp valsts veselības aprūpes sistēmas problēmām un HIV infekcijas izplatību ir skaidri saskatāma. Teritorijās ar ierobežotu veselības aprūpes pakalpojuma pieejamību tiek reģistrēt lielāks stacionēto HIV inficēto pacientu skaits un lielāks letālo iznākumu skaits. Gandrīz divas trešdaļas no HIV inficētiem pacientiem dzīvo Subsahāras Āfrikā. Kamēr Latvijā letalitāte HIV inficēto stacionēto pacientu grupā ir tikai 4%, vairāk nekā viena trešdaļa pacientu Āfrikas slimnīcās nomirst. Saskaņā ar pētījumiem, HIV infekcija valstīs ar ierobežotu veselības aprūpes pieejamību tiek diagnosticēta vēlīni un diagnozes noteikšanas brīdī pacientu CD4 šūnu skaits ir zemāks nekā valstīs ar pietiekamiem finansiāliem resursiem. Ar AIDS nesaistītas saslimšanas HIV pacientu vidū, kā piemēram, kardiovaskulāras slimības tiek diagnosticētas biežāk attīstītās valstīs, radot cita veida izaicinājumus pacienta veselības aprūpei. Šai pacientu grupā ilgtermiņa veiksmīgu terapijas rezultātu sasniegšanai ļoti svarīga ir izpratne par diagnozi, blakussaslimšanām un riska faktoru ietekmes mazināšanu kā profilakses metodi. Atšķirības starp HIV inficētu pacientu stacionēšanas iemesliem ir plaši aprakstītas dažādu valstu publikācijās. Pacienti, kas tiek stacionēti Āfrikā biežāk ir ar zemāku vidējo CD4 šūnu skaitu, vēlīnā slimības stadijā un ar augstāku letalitātes varbūtību stacionēšanas epizodes laikā, salīdzinot ar Eiropas vai Amerikas stacionāriem. Tas neļauj aizmirst par tālākiem mērķiem cīņā pret AIDS.
Even though HIV is a disease which is known for many years and improvements have been made to decrease HIV incidence and mortality all over the world, hospitalization rates remain high, especially in resource limited areas. This research paper aims to comprehensively review up to date literature on the reasons and differences of HIV positive patients leading to their hospitalization by comparing Europe, Africa and North and South America. Exclusion and inclusion criteria were defined and those publications which fulfilled the following criteria were included in this study: population size >100 patients, published after 2005 and in English. In general, Europe fares well compared to other continents but there are exceptions such as in Latvia where numbers of newly diagnosed HIV and AIDS cases remain high. By analyzing various publications, correlations between the wealth of a country and the health status of a person with HIV can be drawn. Resource limited areas have higher numbers of inpatient morbidity and mortality. Nearly two thirds of all people living with HIV worldwide are living in Sub-Saharan area. Whereas Latvia has an inpatient mortality of approximately 4%, more than one third won`t survive their hospital stay in Africa. In line with this, HIV tends to be diagnosed in resource limited areas at a later stage and with a lower CD4+ cell count. Non-AIDS-defining illnesses, cardiovascular diseases and substance abuse occur more commonly in high income countries causing other challenges to be faced. In this population, especially awareness and diagnoses of comorbidities and the prevention of risk factors is very important to receive a good long term-outcome. It can be concluded that differences in hospitalizations of HIV positive patients can be described in different countries worldwide. Patients were hospitalized in Africa at a lower average/median CD4+ T cell count, at a later stage and a higher inpatient mortality compared to resource richer areas such as Europe or America. This leads to the urgent call not to lose sight of further combating against HIV.
Even though HIV is a disease which is known for many years and improvements have been made to decrease HIV incidence and mortality all over the world, hospitalization rates remain high, especially in resource limited areas. This research paper aims to comprehensively review up to date literature on the reasons and differences of HIV positive patients leading to their hospitalization by comparing Europe, Africa and North and South America. Exclusion and inclusion criteria were defined and those publications which fulfilled the following criteria were included in this study: population size >100 patients, published after 2005 and in English. In general, Europe fares well compared to other continents but there are exceptions such as in Latvia where numbers of newly diagnosed HIV and AIDS cases remain high. By analyzing various publications, correlations between the wealth of a country and the health status of a person with HIV can be drawn. Resource limited areas have higher numbers of inpatient morbidity and mortality. Nearly two thirds of all people living with HIV worldwide are living in Sub-Saharan area. Whereas Latvia has an inpatient mortality of approximately 4%, more than one third won`t survive their hospital stay in Africa. In line with this, HIV tends to be diagnosed in resource limited areas at a later stage and with a lower CD4+ cell count. Non-AIDS-defining illnesses, cardiovascular diseases and substance abuse occur more commonly in high income countries causing other challenges to be faced. In this population, especially awareness and diagnoses of comorbidities and the prevention of risk factors is very important to receive a good long term-outcome. It can be concluded that differences in hospitalizations of HIV positive patients can be described in different countries worldwide. Patients were hospitalized in Africa at a lower average/median CD4+ T cell count, at a later stage and a higher inpatient mortality compared to resource richer areas such as Europe or America. This leads to the urgent call not to lose sight of further combating against HIV.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
HIV inficētu pacientu stacionēšanas iemesli un atšķirības, CD4+ šūnu skaits stacionēšanas un komplikāciju rašanās laikā, reasons and differences of HIV hospitalizations, CD4+ cell count of HIV patients upon admission and its complications