Changing patterns of presentations of patients with HIV-related disease at a tertiary referral centre and its implications for physician training.

Abstract

Highly active antiretroviral therapy (HAART) has been shown to be highly effective in controlling HIV-related disease progression. Our objective was to determine whether HAART had altered the spectrum of HIV-related disease presentations at a tertiary medical referral centre and if a change in the clinical presentations of HIV-infected individuals to the hospital had impacted on physicians' training. A retrospective study which examined all admissions of HIV-infected patients identified between 1 October 1996 to 30 September 1998 using a hospital-designed computer database was undertaken at the Beth Israel Deaconess Medical Center (BIDMC) tertiary medical referral centre. All medical residents were surveyed in order to assess their knowledge of HIV-associated admissions and their confidence treating HIV-infected patients. There were significant changes in the admitting diagnosis for HIV-related illness between 1996 and 1998. Admissions for opportunistic infections (OIs) declined whereas admissions with bacterial infections increased significantly. Use of HAART remained stable between the 2 years of the study. Physicians' overestimated the use of HAART and only 8% of residents felt very comfortable taking care of an HIV-infected patient. In conclusion, the spectrum of presentations with HIV-related disease to a tertiary referral centre continues to change in the HAART era and impacts on physicians' experience of the management of HIV disease.

• Authors: R Segal, M C Poznansky, L Connors, K Sands, T Barlam
• Journal: International journal of STD & AIDS (Int J STD AIDS) Vol. 12 Issue 7 Pg. 453-9 (Jul 2001) ISSN: 0956-4624 [Print] England
• PMID: 11394981 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-HIV Agents

Topics

• AIDS-Related Opportunistic Infections (epidemiology, etiology)
• Adult
• Anti-HIV Agents (therapeutic use)
• Antiretroviral Therapy, Highly Active
• Bacterial Infections (epidemiology, etiology)
• Boston (epidemiology)
• Clinical Competence (standards)
• Cohort Studies
• Community Health Centers
• Female
• HIV Infections (complications, drug therapy)
• HIV-1
• Health Knowledge, Attitudes, Practice
• Humans
• Internship and Residency
• Male
• Patient Admission (statistics & numerical data)
• Physicians (standards)
• Retrospective Studies
• Surveys and Questionnaires