Patternsand causes of hospitalization among human immunedeficiency virus infected adult patient on antiretroviral therapy admitted to jimma university medical center medical wards, jimma town,jimma zone,oromia regional state,southwest Ethiopia

Abstract

Background Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) have caused the world most shocking tragedy and risk. Morbidity and mortality can occur due to direct effect of virus itself, Opportunistic infection related or malignancies. While the causative agents of the secondary infections are characteristically opportunistic organisms such as P. jiroveci, atypical mycobacterium, CMV, and other organisms that do not ordinarily cause disease in the absence of a compromised immune system, they also include common bacterial and mycobacterial pathogens. Overall, the clinical spectrum of HIV disease is constantly changing as patients live longer and new and better approaches to treatment and prophylaxis are developed. In addition to the classic AIDS-defining illnesses, patients with HIV infection also have an increase in serious non-AIDS illnesses, including non-AIDS related cancers and cardiovascular, renal, and hepatic disease. Non-AIDS events dominate the disease burden for patients with HIV infection receiving ART, While AIDS-related illnesses are the leading cause of death in patients with HIV infection, they account for fewer than 50% of deaths. Non-AIDS-defining malignancies, liver disease, and cardiovascular disease each account for 10–15% of deaths in patients with HIV infection. Efforts have been made to reduce HIV/AIDS-related mortality by delivering antiretroviral therapy treatment. ART has modified the natural history of HIVinfection: the incidence of opportunistic infection has decreased and mortality associated to HIV has improved dramatically. It is worrisome that even with the provision of free ARV drugs in many parts of Sub-Saharan African many HIV/AIDS patients from this region still suffer from advanced HIV related diseases, whereas in the developed world, morbidity is mainly due to HIVunrelated diseases. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. Mortality among patients on HAART is associated with high baseline levels of HIV RNA, WHO stage III or IV at the beginning of treatment, low body mass index, severe anemia, low CD4+ cell count, type of ART treatment, gender, resource-poor settings, and poor adherence to HAART.