ABSTRACT
Racial disparities in HIV-care include the disproportionate impact of HIV/AIDS on African Americans. We conducted a retrospective review of 1,855 cases at 78 hospitals in nine cities to evaluate racial variations in inpatient care for AIDS-related Pneumocystis pneumonia (PCP) shortly after the introduction of highly active anti-retroviral therapies. While inpatient HIV-related PCP mortality was comparable between Whites and Hispanics (p=0.94), African Americans were less likely than Whites to die in-hospital (AOR 0.69, 95% CI 0.48, 0.99) and more likely to receive timely anti-PCP medications (AOR 1.67, 95% CI 1.21, 2.30) and timely corticosteroids (AOR 1.46, 95% CI 1.17, 1.82). Findings were compared with those from our study involving 1,547 patients at 82 hospitals in five cities over the first decade of the AIDS epidemic. In contrast to the first study, in the second decade African Americans were more likely to receive timely and appropriate therapy for HIV-related PCP, and resultantly were more likely to survive the hospitalization.
Subject(s)
AIDS-Related Opportunistic Infections/ethnology , Black or African American/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Hospital Mortality/ethnology , Pneumonia, Pneumocystis/ethnology , White People/statistics & numerical data , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/mortality , Adolescent , Adrenal Cortex Hormones/therapeutic use , Adult , Antiretroviral Therapy, Highly Active , Female , Hospitalization/statistics & numerical data , Hospitals, Urban , Humans , Male , Middle Aged , Pneumonia, Pneumocystis/drug therapy , Pneumonia, Pneumocystis/mortality , Retrospective Studies , Treatment Outcome , United States , Young AdultABSTRACT
BACKGROUND AND OBJECTIVE: The antiretroviral nevirapine can cause severe hepatotoxicity when used 'off-label' for preventing mother-to-child HIV transmission (PMTCT), newborn post-exposure prophylaxis and for pre- and post-exposure prophylaxis among non-HIV-infected individuals. We describe the incidence of hepatotoxicity with short- versus long-course nevirapine-containing regimens in these groups. METHODS: We reviewed hepatotoxicity cases among non-HIV-infected individuals and HIV-infected pregnant women and their offspring receiving short- (