Background: The incidence of Intracranial Hemorrhage (ICrH) in HIV patients is on the rise in the United States, especially after the development of newer antiretroviral drugs. This study determines the trends of ICrH in HIV patients in the United States.
Design/Methods: Data from the Nationwide Inpatient Sample (NIS) and Healthcare Cost and Utilization Project (HCUP) were analyzed for years 2002-2012.Hospitalizations with HIV positive status were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 042, V08 and ICrH by 430.xx-432.xx. Cochrane Armitage trend test and multivariate regression were used to analyze temporal trends and the potential reasons for temporal changes over the years.
Results: A total of 2,584,548 hospitalizations with HIV status were made from 2002 to 2012. Of these, 10,292 (0.40%) admissions were due to ICrH or developed ICrH during hospitalization. Concurrent trend of ICrH and HIV increased from 0.34% to 0.45% in 2012 (ptrend<0.001). This trend increased annually by 3.5% (OR 1.035; 95% CI 1.01-1.05;p<0.001). The temporal rise was explained by changes in demographics and co-morbidities. Amongst HIV-related hospitalizations, Age (10 year increase) (OR 1.23; 95% CI 1.09-1.43; p<0.001), African-American race (OR 1.25; 95% CI 1.09-1.43; p<0.001), Hispanic race (OR 1.29; 95% CI 1.07-1.55; p<0.001) and history of Hypertension (OR 1.97; 95% CI 1.76-2.22; p<0.001) were significantly associated with the development of ICrH, However females had lower odds of developing ICrH(OR 0.80; 95% CI 0.71-089; p<0.001).
Conclusions: These data suggest that the incidence of ICrH among hospitalized adults with HIV infection continue to increase. This increasing ICrH was explained by an aging HIV population, changing demographics and chronic comorbidities, but questions still remain regarding unexplained factors which merit in-depth study.