Email this article 
Hide
Show all
Original Research
Profile of presentation of HIV-positive patients to an emergency department in Johannesburg, South Africa
Submitted: 11 October 2020 | Published: 29 January 2021
About the author(s)
Abdullah E. Laher, Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaWillem D.F. Venter, Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Guy A. Richards, Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Fathima Paruk, Department of Critical Care, University of Pretoria, Pretoria, South Africa
Abstract
Background: Despite improved availability and better access to antiretroviral therapy (ART), approximately 36% of human immunodeficiency virus (HIV)-positive South Africans are still not virally suppressed.
Objective: The aim of this study was to describe the patterns of presentation of HIV-positive patients to a major central hospital emergency department (ED).
Methods: In this prospectively designed study, consecutive HIV-positive patients presenting to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) adult ED were enrolled between 07 July 2017 and 18 October 2018.
Results: A total of 1224 participants were enrolled. Human immunodeficiency virus was newly diagnosed in 212 (17.3%) patients, 761 (75.2%) were on ART, 245 (32.2%) reported ART non-adherence, 276 (22.5%) had bacterial pneumonia, 244 (19.9%) had tuberculosis (TB), 86 (7.0%) had gastroenteritis, 205 (16.7%) required intensive care unit admission, 381 (31.1%) were admitted for ≥ 7 days and 166 (13.6%) died. With regard to laboratory parameters, CD4 cell count was < 100 cell/mm3 in 527 (47.6%) patients, the viral load (VL) was > 1000 copies/mL in 619 (59.0%), haemoglobin was < 11 g/dL in 636 (56.3%), creatinine was > 120 µmol/L in 294 (29.3%), lactate was > 2 mmol/L in 470 (42.0%) and albumin was < 35 g/L in 633 (60.8%).
Conclusion: Human immunodeficiency virus-positive patients presenting to the CMJAH ED demonstrated a high prevalence of opportunistic infections, required a prolonged hospital stay and had high mortality rates. There is a need to improve the quality of ART services and accessibility to care.
Keywords
Metrics
Total abstract views: 4188Total article views: 5550
Crossref Citations
1. Prognostic Value of Procalcitonin in Febrile People Living with Human Immunodeficiency Virus (PLWH) Admitted to the Emergency Department
Luigi Celani, Luigi Carbone, Francesco Ceppa, Andrea Piccioni, Davide Antonio Della Polla, Marta Chiuchiarelli, Antonella Cingolani, Giuseppe De Matteis, Rita Murri, Antonio Gasbarrini, Francesco Franceschi, Marcello Covino
Medicina vol: 61 issue: 2 first page: 240 year: 2025
doi: 10.3390/medicina61020240
2. Southern African Journal of HIV Medicine August 2021
David C. Spencer
Southern African Journal of HIV Medicine vol: 22 issue: 1 year: 2021
doi: 10.4102/sajhivmed.v22i1.1309
3. Advanced HIV disease and engagement in care among patients on antiretroviral therapy in South Africa: results from a multi-state model
Gabriela E. Patten, Jonathan Euvrard, Nanina Anderegg, Andrew Boulle, Kirsten D. Arendse, Erin von der Heyden, Nathan Ford, Mary-Ann Davies
AIDS vol: 37 issue: 3 first page: 513 year: 2023
doi: 10.1097/QAD.0000000000003442
4. The geography of emergency department-based HIV testing in South Africa: Can patients link to care?
Bhakti Hansoti, Anant Mishra, Aditi Rao, Lucy Chimoyi, Andrew D. Redd, Steven J. Reynolds, David F. Stead, John Black, Roshen Maharaj, Elizabeth Hahn, Pamela Mda, Nomzamo Mvandaba, Yandisa Nyanisa, Victoria Chen, Katie Clark, Sofia Ryan, Thomas C. Quinn
EClinicalMedicine vol: 40 first page: 101091 year: 2021
doi: 10.1016/j.eclinm.2021.101091
5. Predictors of in‐hospital mortality among HIV‐positive patients presenting with an acute illness to the emergency department
AE Laher, F Paruk, WDF Venter, OA Ayeni, GA Richards
HIV Medicine vol: 22 issue: 7 first page: 557 year: 2021
doi: 10.1111/hiv.13097
6. In-hospital mortality of acute HIV-associated pulmonary morbidity among COVID-19 negative medical admissions to Dr. George Mukhari Academic Hospital
Lehlonono Seema, Matlawene John Mpe
Journal of the Pan African Thoracic Society vol: 4 first page: 124 year: 2023
doi: 10.25259/JPATS_45_2022
7. Evaluation of HIV screening in hospital emergency services. Systematic review
Livia Valero-Verdejo, César Hueso-Montoro, María Ángeles Pérez-Morente
International Emergency Nursing vol: 71 first page: 101355 year: 2023
doi: 10.1016/j.ienj.2023.101355
8. Supporting re-engagement with HIV services after treatment interruption in South Africa: a mixed method program evaluation of MSF’s Welcome Service
Kirsten D. Arendse, Caroline Walker, Colin Pfaff, Keitumetse Lebelo, Tali Cassidy, Petros Isaakidis, Erin von der Heyden, Fareed Abdullah, Tom Ellman, Ingrid T. Katz, Jonathan Euvrard, Claire M. Keene
Scientific Reports vol: 14 issue: 1 year: 2024
doi: 10.1038/s41598-024-57774-9
9. Predictors of prolonged hospital stay in HIV-positive patients presenting to the emergency department
Abdullah E. Laher, Fathima Paruk, Guy A. Richards, Willem D. F. Venter, Saeed Ahmed
PLOS ONE vol: 16 issue: 4 first page: e0249706 year: 2021
doi: 10.1371/journal.pone.0249706
10. Development and internal validation of the HIV In‐hospital Mortality Prediction (HIV‐IMP) risk score
Abdullah E. Laher, Fathima Paruk, Willem D. F. Venter, Oluwatosin A. Ayeni, Feroza Motara, Muhammed Moolla, Guy A. Richards
HIV Medicine vol: 23 issue: 1 first page: 80 year: 2022
doi: 10.1111/hiv.13159