Fewer HIV hospitalizations since combo drug therapy introduced

People with HIV are being hospitalized in Ontario significantly less often than they were 15 years ago when combination antiretroviral drug therapy (cART) was introduced, new research has found.

However, women with HIV are still hospitalized more than men with HIV as are low-income people with HIV compared with high-income people with HIV, according to a study by Tony Antoniou, a pharmacist and researcher in the Department of Family Medicine at St. Michael’s Hospital.

Immigrants with HIV who had been in Ontario three years or less had lower rates of hospital admissions than Canadian-born people with HIV or immigrants who had been in Ontario longer than three years.

His study was conducted using data at the Institute for Clinical Evaluative Sciences (ICES) and appears in the online journal Open Medicine.

Combination antiretroviral drug therapy, introduced in 1996-97, involves the use of three or more drugs to lower the amount of HIV in the body and prevent the progression of AIDS and death.

“Although our study is overall a ‘good news’ story for persons with HIV in Ontario, the differences in rates of hospitalization over the past decade suggest that women and low-income individuals living with HIV may face challenges accessing medication and community-based care,” said Dr. Antoniou.

While rates of all hospital admissions among all persons with HIV in Ontario declined by about 2 per cent per year between 2002 and 2008, rates in women and low-income persons with HIV were 15 per cent and 21 per cent higher than those of men and high-income patients, respectively, during this period. In addition, rates of hospital admission attributable to HIV itself were 30 per cent higher in low-income persons with HIV relative to high-income persons.

Dr. Antoniou said he believes that universal access to life-saving anti-HIV treatments would be one way to address these disparities, but that, “We need to do more research to understand and address the root causes of these differences, to ensure that all persons with HIV are able to benefit equally from the advances that have been made in managing this illness.”


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