Human Immunodeficiency Viral Infection and Status Epilepticus in United States (2002–2009)

Abstract

Objective—To determine the association between human immunodeficiency virus (HIV) infection and
status epilepticus and compare the outcomes of patients with status epilepticus with or without underlying
HIV infection.
Methods—Patients with primary diagnosis of status epilepticus (cases) and status asthmaticus (controls)
were identified from the 2002–2009 Nationwide Inpatient Sample (NIS) which is representative of all
admissions in the United States. We performed logistic regression analysis adjusting for age, gender, comorbid conditions, including hypertension, diabetes mellitus (DM), renal failure, alcohol use, and opportunistic infections. We compared the in hospital outcomes among patients admitted with status epilepticus
in strata defined by underlying HIV infection.
Results—The rate of concurrent status epilepticus and HIV has increased over the last 7 years in hospitalized patients with status epilepticus in United States (0.14%–0.27% p<0.0001). The HIV infection was significantly associated with status epilepticus (odds ratio [OR]: 2.2; 95% confidence interval [CI]: 1.8–2.6;
p<0.0001)) after adjusting for age, gender, opportunistic infections, and cardiovascular risk factors. The inhospital mortality was significantly higher while discharge with none or minimal disability was significantly lower in status epilepticus patients with underlying HIV infection (17.5% vs. 9.9%, p<0.0001) and
(50.4% vs. 63.3%, p<0.0001), respectively.
Conclusions—Our study suggests that there is a direct association between HIV infection and status epilepticus. The proportion of patients admitted with concurrent status epilepticus and HIV infections is
increasing and such patients have higher rates of poor discharge outcomes.