Table 4.
Multivariable Analyses of Factors Associated With Cause-Specific Hospitalization at 9 Sites With ICD-9 Dataa
| Characteristic | Adjusted Incidence Rate Ratio (95% CI)a |
|||||
|---|---|---|---|---|---|---|
| All-Cause | Non–AIDS-Defining Infection | Cardiovascular | Gastrointestinal/Liver | Psychiatric | Endocrine | |
| HIV control status | ||||||
| Medical control | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| Elite control | 1.99 (1.29–3.06) | 0.32 (.08–1.30) | 3.19 (1.50–6.79) | 1.32 (.52–3.33) | 3.98 (1.54–10.28) | 1.14 (.32–4.06) |
| Low viremia | 1.39 (1.26–1.54) | 1.57 (1.31–1.88) | 1.11 (.87–1.42) | 0.91 (.68–1.23) | 1.65 (1.15–2.37) | 1.54 (1.14–2.08) |
| High viremia | 1.79 (1.61–1.99) | 2.48 (2.10–2.93) | 1.18 (.92–1.51) | 1.15 (.85–1.54) | 3.14 (2.35–4.21) | 1.42 (1.00–1.99) |
| Age, yb | ||||||
| 18–34 | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| 35–49 | 1.10 (.94–1.28) | 1.09 (.87–1.36) | 2.20 (1.25–3.88) | 1.23 (.81–1.87) | 1.07 (.64–1.78) | 1.72 (1.00–2.94) |
| 50–64 | 1.36 (1.15–1.59) | 1.18 (.92–1.51) | 3.63 (2.05–6.44) | 1.26 (.79–2.02) | 0.72 (.42–1.26) | 2.33 (1.38–3.93) |
| ≥65 | 2.24 (1.77–2.83) | 1.44 (1.00–2.07) | 7.86 (4.06–15.20) | 2.25 (1.25–4.08) | 0.94 (.35–2.49) | 3.95 (2.02–7.72) |
| Race | ||||||
| White | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| Black | 1.05 (.92–1.20) | 0.85 (.69–1.04) | 1.25 (.92–1.69) | 0.94 (.68–1.30) | 1.17 (.80–1.71) | 1.39 (.96–2.03) |
| Hispanic | 0.84 (.72–.97) | 0.71 (.56–.88) | 1.04 (.75–1.43) | 0.97 (.70–1.35) | 0.79 (.48–1.30) | 1.10 (.66–1.86) |
| Other/unknown | 0.75 (.52–1.09) | 0.53 (.29–.96) | 1.08 (.48–2.46) | 0.50 (.17–1.42) | 0.80 (.33–1.97) | 0.51 (.16–1.67) |
| Sex | ||||||
| Male | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| Female | 1.23 (1.09–1.39) | 1.19 (.99–1.42) | 0.98 (.76–1.26) | 1.09 (.80–1.48) | 0.93 (.66–1.33) | 1.30 (.91–1.86) |
| HIV risk factorc | ||||||
| Heterosexual | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| MSM | 0.83 (.72–.96) | 1.08 (.88–1.33) | 0.62 (.46–.85) | 0.92 (.64–1.30) | 0.96 (.63–1.46) | 0.73 (.46–1.14) |
| IDU | 1.23 (1.06–1.42) | 1.56 (1.26–1.92) | 0.71 (.51–.97) | 1.47 (1.03–2.10) | 2.15 (1.44–3.33) | 1.21 (.77–1.89) |
| Other/unknown | 1.21 (.96–1.53) | 1.23 (.87–1.74) | 0.74 (.46–1.20) | 1.20 (.71–2.04) | 1.58 (.61–4.08) | 1.79 (.93–3.48) |
| CD4 cell count, cells/mm3d | ||||||
| >750 | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| 501–750 | 1.11 (.99–1.23) | 1.08 (.90–1.28) | 0.89 (.70–1.13) | 1.11 (.83–1.50) | 1.32 (.95–1.84) | 1.18 (.82–1.71) |
| ≤500 | 1.28 (1.15–1.43) | 1.28 (1.08–1.52) | 1.00 (.78–1.30) | 1.17 (.86–1.58) | 1.16 (.82–1.63) | 1.18 (.83–1.69) |
| Hepatitis statuse | ||||||
| HIV monoinfection | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| HIV/HBV coinfection | 1.07 (.78–1.46) | 1.21 (.87–1.69) | 0.72 (.32–1.63) | 1.03 (.54–1.99) | 0.87 (.38–1.98) | 0.94 (.34–2.58) |
| HIV/HCV coinfection | 1.36 (1.17–1.57) | 1.33 (1.07–1.66) | 1.53 (1.11–2.10) | 1.33 (.94–1.90) | 1.29 (.85–1.96) | 1.40 (.90–2.16) |
| HIV/HBV/HCV triple infection | 1.40 (.95–2.08) | 1.18 (.78–1.80) | 2.41 (1.17–4.96) | 1.51 (.80–2.86) | 0.25 (.04–1.74) | 0.80 (.32–2.01) |
| Unknown | 1.06 (.94–1.20) | 0.94 (.78–1.13) | 1.27 (.98–1.65) | 1.13 (.84–1.52) | 1.48 (1.02–2.17) | 0.73 (.48–1.09) |
| Annual outpatient HIV visits | ||||||
| 1–2 | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| 3–4 | 0.93 (.82–1.06) | 0.81 (.65–1.01) | 0.87 (.58–1.30) | 1.04 (.73–1.48) | 0.77 (.54–1.09) | 1.06 (.70–1.60) |
| 5–6 | 1.30 (1.13–1.48) | 1.27 (1.01–1.59) | 1.24 (.83–1.84) | 1.52 (1.03–2.24) | 0.97 (.65–1.44) | 1.96 (1.24–3.11) |
| ≥7 | 2.68 (2.34–3.07) | 2.64 (2.11–3.31) | 3.04 (2.02–4.57) | 3.88 (2.76–5.46) | 2.01 (1.43–2.82) | 3.53 (2.32–5.36) |
| Insuranced | ||||||
| Private | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| Medicaid | 1.72 (1.47–2.02) | 1.91 (1.47–2.47) | 2.15 (1.42–3.27) | 1.21 (.82–1.78) | 2.47 (1.55–3.93) | 1.57 (.91–2.72) |
| Medicare/dual eligible | 1.81 (1.53–2.15) | 2.08 (1.59–2.72) | 2.08 (1.38–3.13) | 1.29 (.86–1.92) | 2.78 (1.72–4.48) | 2.45 (1.47–4.08) |
| Ryan White/uninsured | 1.08 (.91–1.28) | 1.26 (.96–1.67) | 1.44 (.94–2.21) | 0.70 (.45–1.09) | 1.94 (1.21–3.10) | 1.14 (.65–2.02) |
| Unknown | 0.99 (.75–1.30) | 1.05 (.64–1.72) | 1.98 (1.07–3.67) | 0.56 (.22–1.45) | 1.51 (.66–3.48) | 0.43 (.08–2.26) |
| Calendar year | ||||||
| 2005 | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) | 1.0 (Reference) |
| 2006 | 0.95 (.81–1.10) | 0.85 (.66–1.10) | 1.43 (.97–2.12) | 0.94 (.58–1.52) | 0.49 (.32–0.76) | 1.33 (.75–2.38) |
| 2007 | 1.10 (.95–1.27) | 1.01 (.78–1.31) | 1.41 (.97–2.04) | 1.06 (.67–1.69) | 0.68 (.43–1.08) | 1.68 (1.02–2.74) |
| 2008 | 1.04 (.90–1.20) | 0.94 (.74–1.20) | 1.26 (.87–1.84) | 1.18 (.75–1.86) | 0.74 (.49–1.12) | 1.42 (.83–2.44) |
| 2009 | 1.04 (.90–1.19) | 0.92 (.72–1.16) | 1.13 (.78–1.65) | 1.49 (.97–2.28) | 0.42 (.28–.64) | 1.82 (1.02–3.23) |
| 2010 | 1.01 (.88–1.16) | 0.88 (.69–1.13) | 1.33 (.92–1.93) | 1.42 (.93–2.15) | 0.74 (.51–1.10) | 1.47 (.87–2.47) |
| 2011 | 0.96 (.84–1.11) | 0.99 (.78–1.26) | 0.88 (.60–1.27) | 1.30 (.85–1.99) | 0.42 (.26–.67) | 1.55 (.92–2.62) |
Abbreviations: CI, confidence interval; HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; ICD-9, International Classification of Diseases, Ninth Revision; IDU, injection drug use; MSM, men who have sex with men.
a The multivariable models used to calculate adjusted incidence rate ratios included all listed variables and also an indicator variable for clinical care site. Results in bold are statistically significant (P ≤ .05).
b Age was assessed on July 1 of each calendar year.
c HIV risk factors were considered mutually exclusive; subjects who reported IDU in addition to any other risk factor were categorized as IDU, men who reported sex with men and women were categorized as MSM.
d CD4 cell counts and insurance data used in these analyses were the first available measurements for each calendar year.
e HBV and HCV status were determined by hepatitis B surface antigen and hepatitis C antibody, respectively, as measured before 1 July of each calendar year. Negative test results were carried backward to the time of study entry, and positive test results were carried forward for all subsequent years.