Profile of presentation of HIV-positive patients to an emergency department in Johannesburg, South Africa

Southern African Journal of HIV Medicine

Field Value
Title Profile of presentation of HIV-positive patients to an emergency department in Johannesburg, South Africa
Creator Laher, Abdullah E. Venter, Willem D.F. Richards, Guy A. Paruk, Fathima
Subject Medicine; HIV; Infectious diseases; Emergency Medicine HIV; emergency department; ART non-adherence; CD4 cell count; HIV viral load; opportunistic infections; hospital admission; mortality
Description Background: Despite improved availability and better access to antiretroviral therapy (ART), approximately 36% of human immunodeficiency virus (HIV)-positive South Africans are still not virally suppressed.Objective: The aim of this study was to describe the patterns of presentation of HIV-positive patients to a major central hospital emergency department (ED).Methods: In this prospectively designed study, consecutive HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) adult ED were enrolled between 07 July 2017 and 18 October 2018.Results: A total of 1224 participants were enrolled. Human immunodeficiency virus was newly diagnosed in 212 (17.3%) patients, 761 (75.2%) were on ART, 245 (32.2%) reported ART non-adherence, 276 (22.5%) had bacterial pneumonia, 244 (19.9%) had tuberculosis (TB), 86 (7.0%) had gastroenteritis, 205 (16.7%) required intensive care unit admission, 381 (31.1%) were admitted for ≥ 7 days and 166 (13.6%) died. With regard to laboratory parameters, CD4 cell count was 100 cell/mm3 in 527 (47.6%) patients, the viral load (VL) was 1000 copies/mL in 619 (59.0%), haemoglobin was 11 g/dL in 636 (56.3%), creatinine was 120 µmol/L in 294 (29.3%), lactate was 2 mmol/L in 470 (42.0%) and albumin was 35 g/L in 633 (60.8%).Conclusion: Human immunodeficiency virus-positive patients presenting to the CMJAH ED demonstrated a high prevalence of opportunistic infections, required a prolonged hospital stay and had high mortality rates. There is a need to improve the quality of ART services and accessibility to care.
Publisher AOSIS
Contributor None
Date 2021-01-29
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Original research
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v22i1.1177
Source Southern African Journal of HIV Medicine; Vol 22, No 1 (2021); 8 pages 2078-6751 1608-9693
Language eng
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Coverage South Africa HIV Medicine Adults
Rights Copyright (c) 2021 Abdullah E. Laher, Willem D.F. Venter, Guy A. Richards, Fathima Paruk