TỈ LỆ NHẬP VIỆN TRONG 6 THÁNG ĐẦU ĐIỀU TRỊ ARV Ở BỆNH NHÂN NHIỄM HIV MỚI ĐƯỢC CHẨN ĐOÁN TẠI BỆNH VIỆN BỆNH NHIỆT ĐỚI NĂM 2023-2024

Abstract

Backround: HIV/AIDS treatment in Vietnam has undergone significant advancements, including the introduction of early antiretroviral therapy (ARV) initiation since 2017 and the adoption of Dolutegravir (DTG) in first-line regimens since 2019. Despite these improvements, newly treated ARV patients still account for a high proportion of hospitalizations among people living with HIV/AIDS. Objective: To determine the hospitalization rate and describe related factors within the first six months of ARV treatment in newly diagnosed HIV/AIDS patients. Methods: A descriptive, prospective cross-sectional study was conducted at the outpatient clinic of the Hospital for Tropical Diseases from October 2023 to July 2024. Participants included HIV-positive patients aged 18 years or older who were newly diagnosed and initiated ARV treatment within one month of diagnosis. Data collected included demographic characteristics, clinical and laboratory findings at ARV initiation, hospitalization frequency, and reasons for hospitalization. Results: Among 76 participants, 26% (20 patients) were hospitalized during the first six months of ARV treatment, with 88% of hospitalizations occurring within the first three months. The primary causes of hospitalization were tuberculosis (34.5%) and Pneumocystis jiroveci pneumonia (26.9%). Risk factors for hospitalization included underweight status (OR = 4.5), clinical stage 3-4 (OR = 21.9), non-adherence to ARV (OR = 4.1), anemia (OR = 6), and CD4+ T-cell count < 200 cells/mm³ (OR = 3.5). Multivariate regression analysis identified clinical stage 3-4 as an independent risk factor for hospitalization (OR = 20.31). Conclusion: The hospitalization rate during the first six months of ARV treatment remains high, particularly among patients in advanced disease stages. Tuberculosis is the most common cause of hospitalization. Recommendations: Early screening and treatment of opportunistic infections, especially tuberculosis, should be prioritized for newly treated HIV patients. Efforts to enhance early HIV detection and diagnosis should be strengthened.