Epidemiology and Outcomes of Hematopoietic Stem Cell Transplant in HIV (+) Patients from 1998 to 2012: A Nationwide Analysis

Abstract

Background

Prior studies have shown that outcomes of hematopoietic stem cell transplantation (HSCT) in HIV (+) patients are similar to HIV (-) patients since effective implementation of HAART by 1998; but they are limited by small sample size or non-inclusion of recent data.

Methods

We queried National Inpatient Sample, a large inpatient dataset in the US, from 1998 to 2012 for HSCT using ICD9 procedure code 41.0. HIV patients were identified by ICD9 diagnostic code of 042, 043, 044, V08 and 079.53. Primary outcome was in-hospital mortality rate and secondary outcome was the in-hospital complication rate of HSCT. Outcomes were assessed by univariate, multivariate regression and matched-pair analysis.

Results

39,517 patients who underwent HSCT were identified. Among these, 108 patients had HIV. There were no differences in in-hospital mortality, intubation, sepsis, bacteremia, or graft vs host disease between HIV (+) and HIV (-) patients after allogeneic and autologous HSCT. In allogeneic HSCT, HIV (+) patients had significantly higher incidence of non-tuberculous mycobacteria and cytomegalovirus infection as compared to HIV (-) patients.

Conclusion

Although HIV (+) patients may have higher risk of certain opportunistic infections, they are not at higher risk of serious in-hospital complications of HSCT. Allogeneic and autologous HSCT can be safely performed in HIV (+) patients.