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Background: We explored the incidence of hospitalization in male and female people living with 4-drug class resistant HIV (4DR-PLWH) enrolled in the PRESTIGIO study.
Methods: We included PLWH with a documented resistance to NRTIs, NNRTIs, PIs and INSTIs. Hospitalization was defined as a hospital admission for any reason with ≥1 overnight stay. Follow-up started from the date of the first 4DR evidence (baseline) until death/loss-to-follow-up/freezing date (December 31st, 2022). Data were reported as median (IQR) or frequency (%). Poisson regression was used to model incidence rates (IR) with 95% confidence intervals (CI).
Results: Overall, 178 4DR-PLWH were included; baseline characteristics, according to gender, are reported in Table 1.
During 1294 PYFU, 122 hospitalizations (28 in females) occurred in 60 4DR-PLWH: 29/60 (48.3%) had >1 hospitalization.
The overall IR for hospitalization was 9.43/100 PYFU (95%CI=7.76-11.10), without a significant difference between males and females (Incidence rate ratio (F/M)=0.77, 95%CI=0.51-1.17, p=0.223). At 7 years after baseline, 34.7% were estimated to have had >=1 hospitalization.
The median duration of hospitalization was 8 days (IQR 4-20). The most frequent causes were non-AIDS-defining infections (n=28, 23%) and major adverse cardiovascular events (MACEs, n=19, 15.6%). Females had no hospitalizations for AIDS-defining events compared to males (0% vs 11.7% (n=11), p=0.049); gender differences appeared with regard to hospitalizations for non-AIDS-defining events (MACEs: 17 (18.1%) and 2 (7.1%) in males vs females, p=0.097; non-AIDS-defining infections: 19 (20.2%) and 9 (32.1%) in males vs females, p=0.084; Figure1).
Conclusion: Women living with HIV multidrug resistance seem to have a lower incidence of AIDS-defining events hospitalizations; women tended to have fewer hospitalizations for MACEs and more hospitalizations for non-AIDS-defining infections than males.