{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:00:44Z","timestamp":1790834444565,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T00:00:00Z","timestamp":1746316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["HIV Medicine"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Human immunodeficiency virus (HIV) remains a significant public health concern worldwide, contributing to notable rates of hospitalization and mortality. This study aimed to analyse HIV disease hospitalization trends and factors associated with in\u2010hospital mortality in Ecuador during 2015\u20132023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Official national hospital discharge data were used. Hospitalization and in\u2010hospital mortality rates were calculated. Multivariable logistic regression was performed to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) to identify factors associated with in\u2010hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Totally 28\u2009408 HIV disease hospitalizations were analysed; the majority were males 61.19% (<jats:italic>n<\/jats:italic>\u2009=\u200917\u2009383). Average hospitalization rate was 18.48 per 100\u2009000 inhabitants. In\u2010hospital deaths accounted for 11.31% (<jats:italic>n<\/jats:italic>\u2009=\u20093214). Older age (\u226540\u2009years) was significantly associated with a higher likelihood of death, particularly in 60\u201369\u2009years (aOR 1.78, 95% CI 1.49\u20132.13) and\u2009\u226570\u2009years (aOR 1.79, 95% CI 1.36\u20132.34). Patients with HIV\u2010related Pneumocystis jirovecii pneumonia (aOR 2.74, 95% CI 2.28\u20133.29) and multiple malignant neoplasms (aOR 4.30, 95% CI 1.66\u201311.15) had the highest mortality likelihood. Although a declining trend in mortality rates was observed throughout 2015\u20132023, there was an increase in mortality probabilities in 2021 which may be linked to healthcare disruptions during the COVID\u201019 pandemic, while subsequent decline in 2022 and 2023 suggests improvements in HIV care access.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While HIV\u2010related hospitalizations and mortality have declined in Ecuador, older patients and those with severe opportunistic infections or malignancies remain at higher risk. These findings underscore the need for early diagnosis, enhanced management of HIV\u2010related complications and sustained antiretroviral therapy (ART) coverage, particularly during public health crises.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hiv.70040","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T01:39:23Z","timestamp":1746409163000},"page":"1108-1124","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["<scp>HIV<\/scp> disease hospitalizations and factors associated with in\u2010hospital mortality in Ecuador: A nationwide analysis from 2015 to 2023"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4525-7534","authenticated-orcid":false,"given":"German Josuet","family":"Lapo\u2010Talledo","sequence":"first","affiliation":[{"name":"Medicine Career Pontificia Universidad Cat\u00f3lica del Ecuador \u2014 Sede Esmeraldas  Esmeraldas Esmeraldas Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8547-3592","authenticated-orcid":false,"given":"\u00c1ngel Luis","family":"Zamora Cevallos","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences Universidad T\u00e9cnica de Manab\u00ed  Portoviejo Manab\u00ed Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0673-3267","authenticated-orcid":false,"given":"Carlos Rafael","family":"Arteaga Reyes","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences Universidad T\u00e9cnica de Manab\u00ed  Portoviejo Manab\u00ed Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4571-1618","authenticated-orcid":false,"given":"Jos\u00e9 Daniel","family":"S\u00e1nchez Redrob\u00e1n","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud y Bienestar Humano Universidad Tecnol\u00f3gica Indoam\u00e9rica  Quito Pichincha Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2754-6172","authenticated-orcid":false,"given":"Jhon Ernesto","family":"Delgado Pinargote","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences Universidad T\u00e9cnica de Manab\u00ed  Portoviejo Manab\u00ed Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3574-8575","authenticated-orcid":false,"given":"\u00c1ngela Mar\u00eda","family":"Espinoza Guevara","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences Universidad T\u00e9cnica de Manab\u00ed  Portoviejo Manab\u00ed Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4513-4056","authenticated-orcid":false,"given":"Edgar Antonio","family":"Men\u00e9ndez Cuadros","sequence":"additional","affiliation":[{"name":"School of Medicine, Faculty of Health Sciences Universidad T\u00e9cnica de Manab\u00ed  Portoviejo Manab\u00ed Ecuador"},{"name":"Maestr\u00eda en Gerontolog\u00eda y Atenci\u00f3n Centrada en la Persona y las Relaciones Universidad Internacional de la Rioja  Logro\u00f1o Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,4]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"World Health Organization.HIV data and statistics[Internet]. Global HIV Programme.2024.https:\/\/www.who.int\/teams\/global\u2010hiv\u2010hepatitis\u2010and\u2010stis\u2010programmes\/hiv\/strategic\u2010information\/hiv\u2010data\u2010and\u2010statistics#:~:text=HIV%20incidence adults%20acquired%20HIV%20in%202023"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-024-19934-4"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1068664"},{"key":"e_1_2_9_5_1","unstructured":"The Joint United Nations Programme on HIV\/AIDS (UNAIDS).Latin America \u2013 2024 global AIDS update[Internet].2024.https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/2024-unaids-global-aids-update-latin-america_en.pdf"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-020-00538-7"},{"key":"e_1_2_9_7_1","unstructured":"Ministry of Public Health of Ecuador.Annual Report on the Epidemiological Situation of HIV in Ecuador 2022 \u2013 Project for the Reduction of High\u2010Impact Chronic 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