Hospitalizations for HIV/AIDS: differences between sexes.

BACKGROUND: Women are especially vulnerable to HIV infection because of biological, social, cultural, and economic factors. In Brazil, AIDS was initially seen predominantly in homosexual men, but the epidemic gradually reached a gender balance as increasing numbers of women became infected with HIV. OBJECTIVE: The aim of the present study was to identify the clinical and epidemiologic characteristics of hospitalized patients with HIV/AIDS of both sexes and compare the differences between them. METHODS: This epidemiologic cross-sectional study evaluated gender differences in demographic, social, clinical, and epidemiologic characteristics of patients diagnosed with HIV/AIDS who were admitted for any reason to the Public Hospital of the Medical School of the Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil. RESULTS: A total of 363 patients were included in the analysis, with a male/female ratio of 1.1:1.0. Forty-one percent of women were pregnant. Mean age at hospitalization and duration of hospitalization were significantly greater among men (P<0.05). Men and nonpregnant women were admitted because of infection significantly more often than were pregnant women (P<0.05). Significantly more single men who reported homosexual, bisexual, or heterosexual behavior associated with drug use were admitted compared with women (P<0.05). Women admitted for treatment were significantly more likely than men to be employed (P<0.05). Adherence to antiretroviral treatment and T CD4+ lymphocyte count indicated important differences between the sexes, with better parameters observed among nonpregnant and pregnant women compared with men. CONCLUSIONS: In the present study, women with HIV/AIDS who were admitted to the hospital for any reason were in better clinical condition compared with men. This observation may be partially explained by the proportion of pregnant women in the study population. These findings suggest that future studies should examine pregnant women with HIV/AIDS as a separate population group to avoid bias in analysis.

Perfil clínico-epidemiológico de pacientes com HIV/Aids internados em um hospital de ensino do Brasil / Clinical and epidemiologic profile of hospitalized patients with HIV/Aids

Objetivo: Traçar o perfil clínico-epidemiológico de pacientes com HIV/Aids hospitalizados. Métodos: Foram selecionados pacientes com diagnóstico de infecção pelo HIV/Aids, acima dos 14 anos de idade, internados no Hospital Escola da Universidade Federal do Triângulo Mineiro, durante os anos de 2004 e 2005, analisando-se variáveis clínico-epidemiológicas e sociodemográficas. Resultados: Foram selecionados 363 pacientes (52,3% masculinos [p=0,2]), que foram submetidos a 592 internações. No ano de 2004 ocorreram 320 internações e em 2005, 272 (p=0,005). A média de idade foi de 35,1 (± 10,3) anos. A maioria dos pacientes era formada por pessoas solteiras, com baixo nível de escolaridade, relatando ser heterossexuais. As infecções motivaram 417 (70,8%) internações, a maioria (81,8%), oportunista. Contagem de linfócitos T CD4+ < 350 céls./mm³ e carga viral > 5.000 cópias RNA/ml foram encontradas em 65,5% e 45% dos pacientes, respectivamente. Óbitos aconteceram em 13,5% dos pacientes, todos por causas infecciosas, e neoplasias foram observadas em 3,3% dos casos. Na ocasião da internação, cerca de 69% dos pacientes estavam em uso da HAART. Conclusões: As características clínico-epidemiológicas encontradas neste estudo são semelhantes às relatadas em outros centros brasileiros e de outros países em desenvolvimento e, em alguns aspectos, parecidas às de nações desenvolvidas. Apesar da terapia anti-retroviral, as infecções oportunistas continuam sendo as principais causas de internação.