Outcomes of HIV-positive Patients With Variceal Upper Gastrointestinal Bleeding in the United States

Background: Variceal upper gastrointestinal bleeding (VUGIB) is associated with significant morbidity and mortality. Historically, patients with human immunodeficiency virus (HIV) infection have experienced worse clinical outcomes compared with HIV-negative individuals. There is a paucity of data on HIV patients suffering from VUGIB. Aim: Our study aims to investigate the impact of HIV status on VUGIB outcomes. Methods: We queried the National Inpatient Sample between 2016 and 2022 using the International Classification of Diseases, Tenth revision codes to identify patients admitted with VUGIB. The patients with HIV were stratified into one group, and the remaining patients were in the control group. A 1:10 propensity-score matched analysis was performed to compare in-hospital outcomes of patients with and without HIV suffering from VUGIB. Results: Our study included 320 HIV patients and 32,320 non-HIV patients who were hospitalized for VUGIB secondary to cirrhosis. After 1:10 propensity-score matching, we had 2760 VUGIB patients without HIV and 300 patients with HIV. All-cause mortality was significantly higher in the HIV group as compared with non-HIV (10% vs. 6%, P <0.01). The median cost of hospital stay was higher in the HIV group, and they were more likely to require ICU and mechanical or NIV. Both groups had similar lengths of stay and comparable use of interventional and diagnostic endoscopy. Conclusions: HIV increases the risk of poor outcomes and mortality in patients with variceal GI bleed.