Evolving Disease Spectrum and Characteristics of People with HIV in Eastern China: A 12-Year Study.

Background: Acquired immunodeficiency syndrome (AIDS) caused by human immunodeficiency virus (HIV) remains a serious public health problem. Opportunistic infections and malignancies are the more frequent causes of hospitalization. We investigated hospitalized people with HIV (PWH) over the past 12 years to determine the types and changing trends of the disease presentation in a large tertiary academic centre in Eastern China. Methods: We evaluated a total of 2,140 hospitalized PWH from January 2010 to December 2021. Demographic, clinical, and laboratory data, as well as opportunistic infections, malignancies, and in-hospital outcomes, were collected and analyzed. Results: Over time, the incidence of opportunistic infections has declined. Conversely, the incidence of malignancies has increased, with non-AIDS-defining cancers (NADCs) occurring more frequently than ADCs. Notably, in 2020-2021, the incidence of NADCs surpassed that of opportunistic infections, marking a novel shift in the disease spectrum. The overall in-hospital mortality rate was 8.1%, and in-hospital mortality gradually decreased over time. Opportunistic infections, malignancies, and CD4+ T cell count were independent predictors of in-hospital mortality. Conclusion: Our study provided a comprehensive description of the disease characteristics of PWH in eastern China over the past 12 years. The disease spectrum of PWH has undergone tremendous changes over time, highlighting the necessity of early HIV diagnosis and broader access to optimal treatment and management strategies.