Comorbidity in HIV-positive patients: A comparative study of HIV- and non-HIV-related hospitalizations in Mississippi, 2010-2011

BACKGROUND: We sought to delineate the demographic differences and to compare the comorbidity level among patients hospitalized with an HIV diagnosis and those hospitalized for all other causes in Mississippi during 2010-2011. We further evaluated the association between HIV-positive status and each of the sixteen studied non-AIDS-defining conditions. METHODS: We analyzed hospital discharge data and implemented the Charlson Comorbidity Index to compute the comorbidity scores. We compared proportions and determined the association between categorical variables with chi-square tests. Means were compared with a t-test. RESULTS: There were 3,692 HIV-related hospitalizations among the 768,602 reported hospitalizations. Compared with non-HIV-infected patients, HIV-infected patients were more likely to be younger (43.9 years versus 50.2 years, p < .001), males (56.7% versus 40.1%, p < .001), African-Americans (79.4% versus 37.3% p < .001), and urban residents (52.6% versus 39.5%, p < .001). Comorbidity evaluation revealed that 48.9% of all HIV-related discharges and 44.7% of all other discharges had a Charlson score of ≥ 1 (p < .001). The leading comorbidities among the HIV-positive patients were moderate/severe renal disease (17.9%), chronic pulmonary disease (12.6%), and non-complicated diabetes (11.2%). Three out of the sixteen examined comorbidities were significantly associated with an HIV-related diagnosis: moderate/severe renal disease (17.9% versus 8.8%), mild liver disease (2% versus 0.9 %), and moderate/severe liver disease (1% versus 0.6%). CONCLUSION: The HIV-positive patients tended to be younger, but had a higher comorbidity score than the non-HIV-positive patients. Additionally, renal disease was a concomitant diagnosis in nearly one fifth of all HIV-related hospitalizations.