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Poor outcomes among critically ill HIV-positive patients at hospital discharge and post-discharge in Guinea, Conakry: A retrospective cohort study

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  • Sebastian Ludwig Albus
  • Rebecca E Harrison
  • Ramzia Moudachirou
  • Kassi Nanan-N’Zeth
  • Benoit Haba
  • Esther C Casas
  • Petros Isaakidis
  • Abdourahimi Diallo
  • Issiaga Camara
  • Marie Doumbuya
  • Fode Bangaly Sako
  • Mohammed Cisse

Abstract

Introduction: Optimal management of critically ill HIV-positive patients during hospitalization and after discharge is not fully understood. This study describes patient characteristics and outcomes of critically ill HIV-positive patients hospitalized in Conakry, Guinea between August 2017 and April 2018 at discharge and 6 months post-discharge. Methods: We carried out a retrospective observational cohort study using routine clinical data. Analytic statistics were used to describe characteristics and outcomes. Results: 401 patients were hospitalized during the study period, 230 (57%) were female, median age was 36 (IQR: 28–45). At admission, 229 patients (57%) were on ART, median CD4 was 64 cells/mm3, 166 (41%) had a VL >1000 copies/ml, and 97 (24%) had interrupted treatment. 143 (36%) patients died during hospitalisation. Tuberculosis was the major cause of death for 102 (71%) patients. Of 194 patients that were followed after hospitalization a further 57 (29%) were lost-to-follow-up (LTFU) and 35 (18%) died, 31 (89%) of which had a TB diagnosis. Of all patients who survived a first hospitalisation, 194 (46%) were re-hospitalised at least once more. Amongst those LTFU, 34 (59%) occurred immediately after hospital discharge. Conclusion: Outcomes for critically ill HIV-positive patients in our cohort were poor. We estimate that 1-in-3 patients remained alive and in care 6 months after their hospital admission. This study shows the burden of disease on a contemporary cohort of patients with advanced HIV in a low prevalence, resource limited setting and identifies multiple challenges in their care both during hospitalisation as well as during and after re-transitioning to ambulatory care.

Suggested Citation

  • Sebastian Ludwig Albus & Rebecca E Harrison & Ramzia Moudachirou & Kassi Nanan-N’Zeth & Benoit Haba & Esther C Casas & Petros Isaakidis & Abdourahimi Diallo & Issiaga Camara & Marie Doumbuya & Fode Ba, 2023. "Poor outcomes among critically ill HIV-positive patients at hospital discharge and post-discharge in Guinea, Conakry: A retrospective cohort study," PLOS ONE, Public Library of Science, vol. 18(3), pages 1-14, March.
    • Handle: RePEc:plo:pone00:0281425
    DOI: 10.1371/journal.pone.0281425
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    1. Fiona Samuels & Maria Stavropoulou, 2016. "‘Being Able to Breathe Again’: The Effects of Cash Transfer Programmes on Psychosocial Wellbeing," Journal of Development Studies, Taylor & Francis Journals, vol. 52(8), pages 1099-1114, August.
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