So-called HIV elite controllers are able to spontaneously suppress HIV viraemias but they also suffer from HIV-induced chronic inflammation that may increase the risk of comorbidities. The authors were interested in the hospitalisation rates and causes of hospitalisation among elite controllers compared to immunologically intact people with medically-controlled HIV. They were able to identify 149 (0.4%) elite controllers among 34,354 people. The unadjusted hospitalisation rates among the medically-controlled, elite controllers, low viraemia and high viraemia groups were: 10.5, 23.3, 12.6 and 16.9 per 100 person-years, respectively. Following adjustment for demographic and clinical factors, elite control was still associated with significantly higher rates of all-cause (adjusted incidence rate ratio [aIRR] 1.77, 95%CI 1.21–2.60), cardiovascular (aIRR 3.19, 95%CI 1.50–6.79) and psychiatric (aIRR 3.98, 95%CI 1.54–10.28) hospitalisation than the medically-controlled group. Non-AIDS-defining infections were the most common reason for hospital admission overall (24.1% of hospitalisations) but were rare among elite controllers (2.7%), who were more likely to be hospitalised due to cardiovascular causes (31.1%). Therefore elite controllers are hospitalised more frequently than people with medically-controlled HIV, and this is usually caused by cardiovascular diseases.
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