Hepatitis C virus (HCV), HIV, and alcohol-related diagnoses (ARD) are each independently associated with an increased risk for medical intensive care unit (MICU) admission, according to a national, retrospective, cohort study published in the Journal of Acquired Immune Deficiency Syndromes.1

Data demonstrate that HCV, HIV, and ARD all independently contribute to an increased risk for all-cause hospitalizations.2-4 Quantification of these medical conditions on MICU admission would be useful for identifying new targets for medical intervention.1

Therefore, researchers used data from 155,550 patients in the Veterans Aging Cohort Study to calculate annual MICU admission rates and relative risk for MICU admission between 1997 and 2014 in patients living with and without HCV, HIV, and ARD.

They found that compared with HCV/HIV/ARD-infected patients, the relative risk for MICU admission decreased among patients with HIV, going from 61% in 1997 to 2009 to 21% in 2010 to 2014. However, this risk increased among patients with HCV, going from 22% in 1997 to 2009 to 54% in 2010 to 2014, and remained consistent among patients with ARD, at 46%.

Thus, viral infections were shown to be associated with serious health conditions requiring MICU admission, but this association could be improved with effective treatment, as demonstrated in patients with HIV. In addition, ARD continues to be associated with substantial MICU admission, and thus, interventions for this modifiable risk factor are needed.

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The authors concluded that, “HCV infection and ARD remain key contributors to MICU admission risk.”1 They added that, “The impact of each of these conditions could be mitigated with [a] combination of treatment of HIV, HCV, and interventions targeting unhealthy alcohol use.”

References

  1. Rentsch CT, Tate JP, Steel T, et al. Medical intensive care unit admission among patients with and without HIV, hepatitis C virus, and alcohol-related diagnoses in the United States: a national, retrospective cohort study, 1997-2014 [published online October 29, 2018]. J Acquir Immune Defic Syndr. doi: 10.1097/QAI.0000000000001904
  2. Rentsch C, Tate JP, Akgun KM, et al. Alcohol-related diagnoses and all-cause hospitalization among HIV-infected and uninfected patients: a longitudinal analysis of United States Veterans from 1997 to 2011. AIDS Behav. 2016;20(3):555-564.
  3. Crowell TA, Gebo KA, Balagopal A, Fleishman JA, Agwu AL, Berry SA; HIV Research Network. Impact of hepatitis coinfection on hospitalization rates and causes in a multicenter cohort of persons living with HIV. J Acquir Immune Defic Syndr. 2014;65(4):429-437.
  4. Gacouin A, Tadie JM, Uhel F, et al. At-risk drinking is independently associated with ICU and one-year mortality in critically ill nontrauma patients. Crit Care Med. 2014;42(4):860-867.