Incidence of hospital admissions for AIDS-defining illness and intensive care unit admissions for individuals with HIV in Texas from 2006 to 2024

Background: Few studies have assessed how the increasing use of highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infections has impacted rates of hospitalization for acquired immunodeficiency syndrome (AIDS)-defining illnesses and HIV-associated critical illness. Methods: Data on all discharges from nonfederal hospitals in the state of Texas from 2006 to 2024 (n = 57,535,409) were parsed to calculate the annual rate of hospitalization with a primary diagnosis of an AIDS-defining illness. The rate of intensive care unit (ICU) admission for individuals with HIV was similarly calculated. Joinpoint regression models were created to describe significant trends in each event rate. Results: AIDS-defining illness hospitalizations decreased from 8.7 per 100,000 Texans in 2006 to 4.0 in 2024. The ICU admission rate for individuals with HIV followed a significantly different path, increasing from 11.2 per 100,000 Texans in 2006 to a peak of 14.3 in 2018, then decreasing ultimately to a rate of 12.2 in 2024. Conclusions: AIDS-defining illness hospitalization became less common over the study period, whereas ICU-level admissions for individuals with HIV did not. Further research should characterize how HIV infection and HAART impact hospitalized patients' presenting diagnoses, complications, and critical illnesses in the modern era.