Moderate/Severe hyponatremia increases the risk of death among hospitalized Chinese human immunodeficiency virus/acquired immunodeficiency syndrome patients

• Published in: PloS one Vol. 9; no. 10; p. e111077
• Main Authors: Xu, Lijun, Ye, Hanhui, Huang, Fan, Yang, Zongxing, Zhu, Biao, Xu, Yan, Qiu, Yunqing, Li, Lanjuan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 31-10-2014; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Acquired Immunodeficiency Syndrome - blood; Acquired Immunodeficiency Syndrome - mortality; Adult; AIDS; Antiretroviral drugs; Biology and Life Sciences; CD4 antigen; China - epidemiology; Correlation analysis; Development and progression; Disease Progression; Female; Hazards; Hemoglobin; Hemoglobins; Highly active antiretroviral therapy; HIV; Hospital Mortality; Human immunodeficiency virus; Humans; Hyponatremia; Hyponatremia - blood; Hyponatremia - mortality; Male; Medicine and health sciences; Middle Aged; Mortality; Patients; Prognosis; Retrospective Studies; Risk Factors; Sexually transmitted diseases; Sodium; Sodium - blood; Statistical models; STD; Survival; Survival Rate; Viruses; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0111077

To evaluate whether the serum sodium concentration is associated with the progression and long-term prognosis of Chinese HIV/AIDS patients.
Three hundred and eighty seven hospitalized patients were recruited into this retrospective cohort study. The strata of serum sodium concentration were moderate/severe hyponatremia, mild hyponatremia and normonatremia. Disease progression was estimated using CD4 counts and the WHO clinical stage. Correlation analysis was used to evaluate the serum sodium concentration with disease progression. The Kaplan-Meier method and the Cox proportional hazards model were used to analyze the effect of different serum sodium levels on survival.
In this study 206 patients (53.2%) had hyponatremia, including 10.6% patients with moderate/severe hyponatremia and 42.6% with mild hyponatremia. The serum sodium concentration was significantly correlated with the HIV/AIDS progression (P<0.001). During the follow-up, 100 patients (25.6%) died. The cumulative survival rates of HIV/AIDS patients were 47.8% ± 8.5% in patients with moderate/severe hyponatremia, 59.8% ± 5.0% with mild hyponatremia and 79.9% ± 3.4% with normonatremia (log-rank P<0.001). After adjusting for sex, age, WHO stage, CD4 count, hemoglobin and albumin, the relative hazard was 3.5 (95% CI: 1.9-6.5) for patients with moderate/severe hyponatremia (P<0.001), and 1.5 (95% CI: 0.9-2.4) for those with mild hyponatremia (P = 0.161), compared with normonatremic patients.
The serum sodium level is closely correlated with the severity of patients. Only moderate/severe hyponatremia affects the prognosis of Chinese HIV/AIDS patients. Earlier intensive medical managements(including HAART)are necessary to increase the survival rates of Chinese HIV/AIDS patients with moderate/severe hyponatremia.