{
  "abstract": "Background and objective: Despite expanded access to antiretroviral therapy (ART), people living with HIV (PLWH) continue to experience high hospitalization rates, particularly in low- and middle-income countries. This study aimed to describe the causes of hospitalization in a cohort of PLWH treated at a high-complexity referral center in Bogotá, Colombia, and to assess variations across the pre-pandemic, pandemic, and post-pandemic periods of COVID-19. Methodology: We conducted a retrospective cohort study including hospitalization episodes among adults with confirmed HIV infection between 2018 and 2024. Clinical characteristics, causes of hospitalization, and outcomes were compared across the epidemiological periods related to the COVID-19 pandemic. Results: A total of 872 hospitalization episodes corresponding to 584 patients were analyzed. The median age was 34 years, and 89.1% were men. Although 68.7% of patients had a history of ART use, 54.8% were admitted with detectable viral load. Non–AIDS-defining causes predominated across all periods (61.8%), with a progressive increase from the pre-pandemic to the post-pandemic period (55.3%, 63.1%, and 70.1%, respectively). A sustained increase in hospitalizations due to mental health disorders was observed over time (4.3%, 4.6%, and 7.8%). Among AIDS-defining conditions, tuberculosis (15.8%) and Pneumocystis jirovecii pneumonia (14.9%) were the most frequent. Hospitalizations due to opportunistic infections were associated with longer length of stay (median 14 vs. 6 days; p < 0.001) and higher 30-day mortality (8.6% vs. 2.6%; p < 0.001) compared with non–AIDS-defining hospitalizations, with a proportional increase in events attributable to tuberculosis and Kaposi sarcoma. Conclusions: An epidemiological transition towards non-AIDS-defining causes of hospitalization is evident, comparable to patterns observed in high-income countries; however, a substantial burden of tuberculosis, Kaposi sarcoma, and late HIV diagnosis persists, likely reflecting ongoing structural gaps in HIV care. Following the COVID-19 pandemic, an increase in hospitalizations related to mental health disorders was observed. Taken together, these findings highlight the urgent need to strengthen early diagnosis, active case finding, and tuberculosis prevention, as well as to enhance the implementation of comprehensive care models that improve retention in care for PLWH in low- and middle-income countries.",
  "abstract_shown": true,
  "affiliations": [
    "Pontificia Universidad Javeriana, Faculty of Medicine, Department of Internal Medicine, Bogotá, Colombia",
    "Division of Infectious Diseases, Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá, Colombia",
    "Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogotá, Colombia",
    "University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America",
    "Division of Infectious Diseases, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America"
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Daniela Lucía Rico-Bolívar"
    },
    {
      "affs": [
        1
      ],
      "name": "Cándida Díaz-Brochero"
    },
    {
      "affs": [
        2
      ],
      "name": "Rebecca Hattemer"
    },
    {
      "affs": [
        3
      ],
      "name": "Camila Andrea Bejarano-Mora"
    },
    {
      "affs": [
        4
      ],
      "name": "Laura Bejarano-Mora"
    },
    {
      "name": "Moises A. Huaman"
    },
    {
      "name": "Sandra Liliana Valderrama-Beltrán"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/206a7sjrvxv0c.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0357788",
  "fulltext_url": null,
  "id": "206a7sjrvxv0c",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0357788",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2725|HIV/AIDS Research and Interventions"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV"
    ],
    [
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      "/Biology and life sciences/Organisms/Viruses/Immunodeficiency viruses/HIV"
    ],
    [
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      "/Biology and life sciences/Organisms/Viruses/RNA viruses/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
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    ],
    [
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    ],
    [
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      "/Medicine and health sciences/Epidemiology/Pandemics"
    ],
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      "plos",
      "/Medicine and health sciences/Health care/Health care facilities/Hospitals/Hospitalizations"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Bacterial diseases/Tuberculosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Infectious diseases/Viral diseases/COVID 19"
    ],
    [
      "plos",
      "/Medicine and health sciences/Medical conditions/Tropical diseases/Tuberculosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Immunodeficiency viruses/HIV"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Retroviruses/Lentivirus/HIV"
    ],
    [
      "plos",
      "/Medicine and health sciences/Public and occupational health/Preventive medicine/Vaccination and immunization/Antiviral therapy/Antiretroviral therapy"
    ]
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  "openalex": "W7214977729",
  "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0357788&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/206a7sjrvxv0c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:37Z",
      "native_id": "10.1371/journal.pone.0357788",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0357788"
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  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "plos:immunology",
      "subfield": "immunology"
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    {
      "field": "biology",
      "origin": "plos:microbiology",
      "subfield": "microbiology"
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    {
      "field": "medicine",
      "origin": "plos:epidemiology",
      "subfield": "epidemiology-public-health"
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  "title": "Causes of hospitalization among people living with HIV in a tertiary-care hospital in Bogotá, Colombia, 2018–2024",
  "title_text": "Causes of hospitalization among people living with HIV in a tertiary-care hospital in Bogotá, Colombia, 2018–2024",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:37Z",
  "url": "https://research.draconitic.com/paper/206a7sjrvxv0c",
  "venue": "PLOS One",
  "versions": []
}