All-cause hospitalisation according to demographic group in people living with HIV in the current ART era: Recent findings from a cohort study in the UK
OBJECTIVE: We investigated differences in all-cause hospitalisation between key demographic groups among people with HIV in the UK in the current ART era. DESIGN/METHODS: We used data from the Royal Free HIV Cohort study between 2007 and 2018. Individuals were classified into five groups: men who have sex with men (MSM), Black African men who have sex with women (MSW), MSW of other ethnicity, Black African women and women of other ethnicity. We studied hospitalisations during the first year after HIV diagnosis (Analysis-A) separately from those more than one year after diagnosis (Analysis-B). In Analysis-A, time to first hospitalisation was assessed using Cox regression adjusted for age and diagnosis date. In Analysis-B, subsequent hospitalisation rate was assessed using Poisson regression, accounting for repeated hospitalisation within individuals, adjusted for age, calendar year, time since diagnosis. RESULTS: The hospitalisation rate was 30.7/100 person-years in the first year after diagnosis and 2.7/100 person-years subsequently; 52% and 13% hospitalisations respectively were AIDS-related. Compared to MSM, MSW and women were at much higher risk of hospitalisation during the first year [aHR (95%CI): 2.7 (1.7-4.3), 3.0 (2.0-4.4), 2.0 (1.3-2.9), 3.0 (2.0-4.5) for Black African MSW; other ethnicity MSW; Black African women; other ethnicity women respectively, Analysis-A] and remained at increased risk subsequently [corresponding aIRR (95% CI): 1.7 (1.2-2.4), 2.1 (1.5-2.8), 1.5 (1.1-1.9), 1.7 (1.2-2.3), Analysis-B]. CONCLUSIONS: In this setting with universal healthcare, substantial variation exists in hospitalisation risk across demographic groups, both in early and subsequent periods after HIV diagnosis, highlighting the need for targeted interventions
