Changing Conditions and Treatments in a Dynamic Cohort of Ambulatory HIV Patients: The HIV Outpatient Study (HOPS)

PURPOSE: Most HIV-infected persons are now treated as ambulatory patients. Obtaining continually updated data about these patients' changing conditions, therapies, and reimbursement is essential to health care provision and planning. The systematic tracking of patient medical and laboratory inf...

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Bibliographic Details
Published in:Annals of epidemiology 1999-08, Vol.9 (6), p.349-357
Main Authors: Moorman, Anne C, Holmberg, Scott D, Marlowe, Steven I, Von Bargen, Jennifer C, Yangco, Bienvenido G, Palella, Frank J, Ward, Douglas J, Loveless, Mark O, Fuhrer, Jack, Joseph, Patrick, Alexander, William A, Aschman, Diane J
Format: Article
Language:English
Subjects:
Adult
AIDS
AIDS/HIV
Ambulatory Care
Anti-HIV Agents - therapeutic use
CD4 Lymphocyte Count
Cohort Studies
Epidemiology
Female
Health Care Utilization
HIV
HIV Infections - drug therapy
HIV Infections - epidemiology
HIV Infections - immunology
HIV Infections - therapy
Human immunodeficiency virus
Humans
Male
Opportunistic Infection
Treatment Outcome
United States - epidemiology
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Summary:PURPOSE: Most HIV-infected persons are now treated as ambulatory patients. Obtaining continually updated data about these patients' changing conditions, therapies, and reimbursement is essential to health care provision and planning. The systematic tracking of patient medical and laboratory information in an ongoing commercial data collection program (The Health Research Network) allows clinicians to better understand health outcomes, practice patterns, and epidemiologic trends for their patients. METHODS: To evaluate trends in conditions and therapies of ambulatory HIV-infected patients, we analyzed such data electronically and prospectively collected in the HIV Outpatient Study (HOPS) from 1992 through 1996 from 1876 patients seen in 11,755 clinic visits to ten HIV clinical practices. RESULTS: Patients were as likely to be diagnosed with Mycobacterium avium complex ([MAC] 5.4 cases per 100 person-years) or wasting syndrome (7.8 cases per 100 person-years), as Pneumocystis carinii pneumonia ([PCP]; 7.6 cases per 100 person-years) or Kaposi sarcoma ([KS]; 6.9 cases per 100 person-years). A nested analysis showed that HIV-infected cigarette smokers were at substantially greater risk of pneumonia (relative hazard [RH] = 2.3), bronchitis (RH = 1.7) and hairy leukoplakia (RH = 1.9) than nonsmokers. By 1996, 35 (56%) of 62 patients with PCP, 9 (30%) of 30 patients with other pneumonias, 28 (90%) of 31 patients with KS, 35 (73%) of 48 patients with MAC, and 24 (63%) of 38 patients with cytomegalovirus retinitis were treated without hospitalization. CONCLUSIONS: The HOPS provides continually updated information on the changing characteristics, conditions, and therapy of ambulatory HIV-infected patients.
ISSN:1047-2797
1873-2585
DOI:10.1016/S1047-2797(99)00005-8