Indications for hospitalization, clinical course, and mortality analysis among patients with HIV/AIDS in a tertiary care hospital: a 5-year retrospective study (2021–2025)

Hospitalization patterns among people living with HIV (PLWH) vary across settings despite widespread use of combined antiretroviral therapy (cART). This five-year retrospective study describes indications for hospitalization, immunological profiles, and factors associated with in-hospital mortality among PLWH admitted to a tertiary referral hospital in Türkiye between 2021 and 2025. The study included 128 adults with laboratory-confirmed HIV infection, with one admission per patient. For repeated hospitalizations, the chronologically selected latest admission during the study period was selected, irrespective of mortality status. Demographic characteristics, immune status, viral loads, comorbidities, and non-mutually exclusive indications for hospitalization were reviewed retrospectively. The primary outcome was documented in-hospital death. An exploratory Firth penalized logistic regression model included age, CD4 < 200 cells/mm³, and malignancy history. The median age was 45 years, and 89.8% of participants were male. At admission, 56.3% had CD4 < 200 cells/mm³, 37.5% had a previously established HIV diagnosis, and 27.3% were receiving cART. Intensive care unit admission occurred in 24.2%. Frequent recorded indications included bacterial infection (58.6%), Pneumocystis jirovecii pneumonia (28.9%), and cytomegalovirus infection (21.9%). Other medical conditions were recorded in 67 patients (52.3%) and were described by organ system category. In-hospital mortality was 15.6% (20/128; 95% confidence interval [CI] 10.3–22.9%). A history of malignancy was associated with higher odds of in-hospital death (adjusted odds ratio 4.00; 95% CI 1.25–12.37; p = 0.020). Advanced immunosuppression and concurrent infectious and non-infectious conditions were common in this selected hospitalized cohort. The association between malignancy history and in-hospital mortality was exploratory, with few events and a wide confidence interval. The findings support attention to timely HIV diagnosis, continuity of care, and comorbidity assessment, with cautious interpretation given the selection strategy and limited adjustment.