Page 209 - SAHCS HIVMed Journal Vol 20 No 1 2019

Page 3 of 6 Original Research

HIV and other comorbidities Of the 47 patients who died during hospitalisation, nine
(19.0%) were HIV-positive.
Of the patients, 1045 (69.0%) had tested negative for HIV at
the time of hospitalisation or during the preceding three There was no significant difference in mortality between the
months, while 288 (19.1%) of the patients did not have a HIV-negative group and the HIV-positive group (p = 0.39).
documented valid test at the time of hospitalisation, that is,
no test had been performed or the last test was performed There was a significant correlation between the type of
over three months prior. Further, 11.9% of the patients had a surgery and HIV status. HIV-positive patients were more
positive HIV test or were known to be HIV-positive.
likely to undergo surgery for hysterectomy because of
suspected cancer, laparotomy because of suspected
For further statistical analysis we excluded all patients gastrointestinal malignancy or procedures for abscesses and
without a valid test. In the group of patients between 15 and plastic surgery. In contrast, this group was less likely to
49 years of age, 110 (23.3%) were HIV-positive. This group, undergo surgery for cerebral shunts, prostatectomy or BLO
usually defined as the adult reproductive-aged group by (Figure 3; Table 2).
UNAIDS and WHO, accounted for 62.0% of all HIV patients
in this cohort. Four children (2.8% of all children) were HIV-
positive. In the group of adults over 49 years, 63 (10.3%) were HIV and malignancies
HIV-infected. Thirty-seven (20.2%) of the patients with histologically
proven malignancies were HIV-positive. When only patients
In the paediatric group, 43.4% did not have a valid HIV test, in the group aged 15–49 years were analysed, 19 (46.3%) of
compared to 9.3% and 17.9% in the adult group and the those with malignancies were HIV-positive. Twelve (63.2%)
group over 49 years of age, respectively. of the patients with cervical cancer were HIV-positive, 14
(51.9%) of the patients with squamous cell carcinoma were
Twenty-one patients were newly diagnosed with HIV HIV-positive and three (13.6%) of the patients with
because of provider-initiated testing and counselling (PITC), adenocarcinoma were HIV-positive. In contrast 9 (4.1%) of all
although this approach was not fully initiated at Karanda patients with prostate cancer were HIV-positive.
Mission Hospital until the beginning of 2017. Seven (33.0%)
of these patients were started on ART before discharge and 18 HIV status
(90.0%) were started on cotrimoxazole prophylaxis. Nega ve Posi ve
100.0
Of the HIV-positive patients, 156/177 (88.1%) were receiving
ART; in two cases it was impossible to establish whether ART
was part of the patient’s treatment. Five (2.8%) of the patients 80.0
were on second-line treatment. Moreover, 88.1% of the
patients were taking cotrimoxazole prophylaxis. A recent 60.0
CD4+ count was available for 117 of the 177 patients (66.0%). Percentage
The mean value was 413 cells/µL (range 0 cells/µL–1510 40.0
cells/µL, median 371 cells/µL, SD 287 cells/µL). Thirty-one
(26.5%) had a CD4+ count below 200 cells/µL. 20.0

0.0
150 Abscess Cataract Hernia Other
Orthopedics other Gynecological other Hysterectomy symptoma c Prostatectomy VP shunts Fractures
Abdominal tumour
Other urology
Cosme c
Orthopedic infec ous
Hysterectomy tumour
Orchidectomy
Number of cases 50 FIGURE 3: HIV status by type of surgery.
100
Type of surgery

TABLE 2: Association between HIV and certain types of surgeries.
Type of surgery Rate of HIV Likelihood to be p Mean age
0
Undifferenated Ca
NHL
Prostate-Ca Benign Adeno-Ca Cervix-Ca Ductal-Ca Sarcoma Serous papillary Ca Chorio-Ca Basal cell Ca Hysterectomy tumour 15 41.7 HIV-positive < 0.001 51.14
Not classified
SCC
HCC
N
%
2.9-fold
0.012
33.20
2.2-fold
32.0
Cosmetic
8
1.8-fold
0.018
Gastrointestinal tumour
25.5
14
53.78
Type of histology Abscess 13 26.0 1.75-fold 0.018 36.44
Cerebral shunts 2 3.7 0.26-fold 0.02 4.96
Ca, cancer; SCC, squamous cell carcinoma; HCC, hepatocellular carcinoma; NHL, non-Hodgkin
lymphoma. Prostatectomy 5 5.9 0.4-fold 0.019 70.09
FIGURE 2: Type of histology. Bilateral orchidectomy 4 4.3 0.3-fold 0.004 71.26
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