Toxoplasmosis hospitalizations in the United States, 2008, and trends, 1993-2008.

Abstract

BACKGROUND:

Toxoplasmosis-related hospitalizations often occur in persons with human immunodeficiency virus (HIV) infection and other causes of immunosuppression.

METHODS:

Using the National Inpatient Sample (NIS) from the Healthcare Cost and Utilization Project, we examined trends in toxoplasmosis-related hospitalizations by HIV infection status from 1993 through 2008, and rates by sex and race or ethnicity in 2008. The NIS is designed to represent a 20% sample of US community hospitals and currently includes information on up to 8 million discharges per year from ∼1000 hospitals. We used International Classification of Diseases, Ninth Revision, Clinical Modification codes 130-130.9 for toxoplasmosis and 042-044/795.8/795.71/V08 for HIV infection.

RESULTS:

Estimated HIV-associated toxoplasmosis hospitalizations increased from 9395 in 1993 to 10583 in 1995 (P = .0002), then dropped to 3643 in 2001 (P < .0001), with similar levels thereafter. The rate of HIV-associated toxoplasmosis hospitalizations among all HIV-related hospitalizations decreased from 3.33% in 1993 to 1.25% in 2008 (P < .0001). Estimated non-HIV-associated toxoplasmosis hospitalizations were less variable from 1993 to 2008 (range, 386-819; 0.0020% in 1993, 0.0015% in 2008). In 2008, the rates of both HIV- and non-HIV-associated toxoplasmosis hospitalizations were higher in Hispanic persons than in white persons.

CONCLUSIONS:

HIV-associated toxoplasmosis hospitalizations dropped markedly after 1995 when highly active antiretroviral therapy was introduced; however, hospitalizations decreased relatively little after 2000, suggesting late diagnosis of some HIV-infected persons or antiretroviral therapy failure. Non-HIV-associated toxoplasmosis hospitalizations have been more stable. The rates of toxoplasmosis-related hospitalizations varied markedly among racial and ethnic groups.

• Authors: Jeffrey L Jones, Jacquelin M Roberts
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 54 Issue 7 Pg. e58-61 (Apr 2012) ISSN: 1537-6591 [Electronic] United States
• PMID: 22267718 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Child
• Child, Preschool
• Ethnicity
• Female
• HIV Infections (complications)
• Hospitalization (statistics & numerical data, trends)
• Humans
• Immunocompromised Host
• Infant
• Infant, Newborn
• Male
• Middle Aged
• Sex Distribution
• Toxoplasmosis (epidemiology)
• United States (epidemiology)
• Young Adult