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Lower AIDS-related hospitalizations in women living with HIV multidrug resistance: results from the PRESTIGIO registry

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.

Dated Thu Jun 15 2023

Authors: R.Papaioannu Borjesson, L.Galli, R.Lolatto, B.Menzaghi, M.Feasi, R.Gulminetti, C.Fornabaio, A.M.Cattelan, S.Bonora, F.Lagi, M.Zazzi, A.Castagna, on behalf of PRESTIGIO Study Group

Affiliations: San Raffaele Vita-Salute University, Milan, Italy, Infectious Diseases Department, San Raffaele Scientific Institute, Milan, Italy, Unit of Infectious Diseases, ASST della Valle Olona, Busto Arsizio, Italy, Ente Ospedaliero Ospedali Galliera, Genova, Italy, Department of Medical Sciences and Infectious Diseases, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, ASST Cremona, Cremona, Italy, Azienda Ospedale-Università Padova, Padova, Italy, Unit of Infectious Diseases, Department of Medical Sciences, University of Turin, Torino, Italy, Infectious and Tropical diseases Unit, Azienda Ospedaliera Universitaria Careggi, Florence, Italy, Department of Medical Biotechnologies, University of Siena, Siena, Italy