Viral clinical profile and mortality outcome of adult HIV-positive patients presenting in the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cross-sectional study

Abstract

BACKGROUND: Human Immunodeficiency Virus has been a global health problem since its identification. Despite a decline in new infections, many patients still present to emergency departments with advanced disease and critical systemic infections in Ethiopia. OBJECTIVE: The main aim of this study was to assess the clinical profile and outcomes of adult HIV-positive patients presenting to the emergency department of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS: This study involved a retrospective cross-sectional electronic medical records review from January 1 to June 30, 2025, taking place in Tikur Anbessa Specialized Hospital adult emergency department. Data was extracted using a structured Kobo tool and then analyzed with SPSS v27. Multivariable logistic regression was applied to identify the factors associated with mortality, with a p-value of < 0.05 regarded as statistically significant. RESULTS: Out of a total of 104 HIV-positive patients included, the mean age was 45.78 ± 14.25 years, and 64(61.5%) were females. The leading clinical presentations were vomiting (14.1%), diarrhea (10.5%), and fatigue (10.1%). Outcomes included ICU admission at 4(3.8%), and emergency department mortality at 15(14.4%). Advanced WHO clinical stage (AOR = 6.068, 95%CI: 1.273-28.880, P = 0.024), high white blood cell count (AOR = 1.205, 95%CI: 1.015-1.429, P = 0.033), and hemoglobin (AOR = 0.704, 95% CI: 0.540-0.918, P = 0.009) were significant independent predictors of mortality. The majority (76.4%) stayed in the ED for ≥ 24 h, with a median stay of 2 days (IQR: 1-3). CONCLUSION: Despite high ART coverage, many HIV-positive adult patients presenting to the TASH ED had advanced disease, high mortality, and prolonged ED length of stay. Advanced WHO clinical stage, elevated white blood cell count, and low hemoglobin were independently associated with increased mortality. Patients with these factors should be prioritized at triage for urgent evaluation and targeted resource allocation, and considered for early aggressive management, to improve patient outcomes and enhance emergency care system performance.