HIV tied to poor outcomes, death in patients with variceal GI bleeding

HIV-positive patients with variceal upper gastrointestinal bleeding (VUGIB) may experience worse clinical outcomes and poor survival, according to a study.

Researchers identified patients admitted with VUGIB from the National Inpatient Sample between 2016 and 2022 using the International Classification of Diseases, Tenth revision codes. Participants were stratified into HIV and control groups. A propensity-score matched analysis was conducted to compare in-hospital outcomes of patients with and without HIV suffering from VUGIB.

A total of 320 people living with HIV and 32,320 non-HIV individuals were hospitalized for VUGIB secondary to cirrhosis. Propensity-score matching yielded 2,760 VUGIB patients without HIV and 300 patients with HIV.

The HIV group showed a significantly higher all-cause mortality rate than the non-HIV group (10 percent vs 6 percent; p<0.01). Moreover, VUGIB patients with HIV had a higher median cost of hospital stay and were more likely to require ICU and mechanical or noninvasive ventilation.

On the other hand, hospital length of stay was similar between groups, as was their use of interventional and diagnostic endoscopy.

“VUGIB is associated with significant morbidity and mortality,” the researchers said. “Historically, patients [living] with HIV have experienced worse clinical outcomes compared with HIV-negative individuals.”