{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T17:58:45Z","timestamp":1781027925036,"version":"3.54.1"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T00:00:00Z","timestamp":1678665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"M\u00e9decins Sans Frontiers"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Optimal management of critically ill HIV-positive patients during hospitalization and after discharge is not fully understood. This study describes patient characteristics and outcomes of critically ill HIV-positive patients hospitalized in Conakry, Guinea between August 2017 and April 2018 at discharge and 6 months post-discharge.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We carried out a retrospective observational cohort study using routine clinical data. Analytic statistics were used to describe characteristics and outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>401 patients were hospitalized during the study period, 230 (57%) were female, median age was 36 (IQR: 28\u201345). At admission, 229 patients (57%) were on ART, median CD4 was 64 cells\/mm<jats:sup>3<\/jats:sup>, 166 (41%) had a VL &gt;1000 copies\/ml, and 97 (24%) had interrupted treatment. 143 (36%) patients died during hospitalisation. Tuberculosis was the major cause of death for 102 (71%) patients. Of 194 patients that were followed after hospitalization a further 57 (29%) were lost-to-follow-up (LTFU) and 35 (18%) died, 31 (89%) of which had a TB diagnosis. Of all patients who survived a first hospitalisation, 194 (46%) were re-hospitalised at least once more. Amongst those LTFU, 34 (59%) occurred immediately after hospital discharge.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Outcomes for critically ill HIV-positive patients in our cohort were poor. We estimate that 1-in-3 patients remained alive and in care 6 months after their hospital admission. This study shows the burden of disease on a contemporary cohort of patients with advanced HIV in a low prevalence, resource limited setting and identifies multiple challenges in their care both during hospitalisation as well as during and after re-transitioning to ambulatory care.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0281425","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T17:26:35Z","timestamp":1678728395000},"page":"e0281425","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Poor outcomes among critically ill HIV-positive patients at hospital discharge and post-discharge in Guinea, Conakry: A retrospective cohort study"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4655-598X","authenticated-orcid":true,"given":"Sebastian Ludwig","family":"Albus","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramzia","family":"Moudachirou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassi","family":"Nanan-N\u2019Zeth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benoit","family":"Haba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther C.","family":"Casas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Isaakidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdourahimi","family":"Diallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Issiaga","family":"Camara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Doumbuya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fode Bangaly","family":"Sako","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Cisse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,13]]},"reference":[{"issue":"9519","key":"pone.0281425.ref001","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1016\/S0140-6736(06)68580-2","article-title":"Scaling up of highly active antiretroviral therapy in a rural district of Malawi: an effectiveness assessment","volume":"367","author":"L Ferradini","year":"2006","journal-title":"Lancet Lond Engl"},{"key":"pone.0281425.ref002","unstructured":"UNAIDS Global report 2010 | UNAIDS Report on the global AIDS epidemic 2010 [Internet]. 2017 [cited 2017 Sep 15]. http:\/\/www.unaids.org\/globalreport\/Global_report.htm"},{"issue":"suppl_2","key":"pone.0281425.ref003","doi-asserted-by":"crossref","first-page":"S106","DOI":"10.1093\/cid\/cix1139","article-title":"Managing Advanced HIV Disease in a Public Health Approach","volume":"66","author":"N Ford","year":"2018","journal-title":"Clin Infect Dis Off Publ Infect Dis Soc Am"},{"key":"pone.0281425.ref004","unstructured":"Rapport Le Prix de l\u2019oubli\u2014Des millions de personnes en Afrique occidentale et centrale restent en marge de la lutte mondiale contre le VIH [Internet]. 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