HIV INFECTION IS ASSOCIATED WITH INCREASED MORBIDITY IN ACUTE ASTHMA EXACERBATION

Abstract

SESSION TITLE: Population-Wide Lung Health: Exposures and Risks SESSION TYPE: Original Investigations PRESENTED ON: 10/23/2019 10:45 AM - 11:45 AM PURPOSE: Increased incidence of asthma has been suggested in HIV-infected patients. We aim to evaluate outcomes of HIV-positive when admitted for an asthma exacerbation. METHODS: A retrospective chart review of patients who were hospitalized between January 2015 and December 2017 with the diagnosis of asthma exacerbation and and a known HIV status was conducted. RESULTS: A total of 1242 patients with asthma were admitted during the 3-year study period. Of these, 462 patients had known HIV status and were included in the study. 358 patients were known HIV negative and 104 patients were HIV positive. There were no differences in baseline demographics including age, gender, body mass index and underlying comorbid conditions. HIV positive patients had higher serum creatinine (1.117 (1.390) vs 0.813 (0.509), p<0.001) and lower serum albumin (3.754 (0.480) vs 3.940 (0.443), p=0.003) when compared to HIV positive patients. HIV positive patients were more likely to require non-invasive positive pressure ventilation (NIPPV) (54.8% vs 25.4%, p=<0.001) and had longer hospital length of stay (LOS) (3.346 days vs 2.813 days, p=0.015) but there were no difference in mechanical ventilation use or need for ICU admission. In a subgroup analysis comparing HIV negative patients with HIV positive patients stratified by CD4 counts, NIPPV use was higher and hospital LOS was longer in HIV patients with CD4 ≥200. In a multivariable regression model, HIV positive status was independently associated with higher need for NIPPV use (OR 2.52, 95% CI 1.43, 4.46, p=0.001). There were no deaths in the study population. CONCLUSIONS: HIV positive patients admitted with asthma exacerbation are more likely to require use of non-invasive positive pressure ventilation and have longer hospital length of stay. CLINICAL IMPLICATIONS: Further research needed to explore management difference between HIV positive and Asthma DISCLOSURES: No relevant relationships by Muhammad Adrish, source=Web Response no disclosure on file for Enny Cancio; No relevant relationships by Nikhitha Mantri, source=Web Response No relevant relationships by Gabriella Roa Gomez, source=Web Response