People with HIV are increasingly admitted for other illnesses as advanced HIV cases decline, study finds

Conditions not classed as signs of advanced HIV are making up a growing share of hospital admissions for people living with HIV at a major hospital in Bogotá, Colombia, a new study has found.

According to a study published in PLOS ONE on 30 September 2026, the fall in admissions for advanced HIV illness is a positive trend that may partly reflect better HIV care in Colombia, the authors say.

Even so, patients admitted with the severe illnesses that mark advanced HIV stayed far longer and were more likely to die.

Tuberculosis became the leading cause among those illnesses in the period after the COVID-19 pandemic.

The research was carried out by a team at Hospital Universitario San Ignacio, a university hospital in Bogotá that receives referrals from other clinics, working with colleagues from the University of Cincinnati in the United States.

PLOS ONE is a peer reviewed journal.

Looking back at 872 admissions

The team reviewed hospital records of 584 adults with HIV (human immunodeficiency virus) who were admitted between January 2018 and June 2024.

Some people were admitted more than once, which brought the total to 872 admissions.

Half of the admissions involved people aged 34 or younger, and about nine in ten involved men.

Each admission was sorted by its main cause into two groups.

The first holds the illnesses that appear when HIV has badly weakened the body's defences, which doctors call AIDS defining illnesses, AIDS being short for acquired immunodeficiency syndrome.

The second holds everything else. The researchers also compared three periods: before, during and after the COVID-19 pandemic.

The last period was the shortest, with 164 admissions, so its figures rest on a smaller base.

Still the biggest cause, but losing ground

Advanced HIV illnesses remained the single biggest cause of admission across the study, at 38.2%.

Taken together, though, all the other conditions made up about six in ten admissions.

Their share climbed from 55.3% before the pandemic, to 63.1% during it, to 70.1% afterwards.

Put the other way, advanced HIV illnesses fell from 44.7% to 29.9%.

The study measured shares of admissions, not how often people with HIV were hospitalised.

It therefore cannot say whether admissions for other conditions actually rose, only that they now make up a bigger slice.

Many of the other admissions were ordinary infections.

About one in three of all admissions were for infections not tied to advanced HIV, making them the second largest group after advanced HIV illnesses.

Stomach and gut infections were the most common, followed by pneumonia.

The authors note that in Europe and the United States, such admissions more often involve heart disease and cancers unrelated to AIDS.

The Bogotá figures sit between two reference points the authors cite.

Earlier studies of hospitals in Medellín, another Colombian city, put advanced HIV illnesses at roughly 55% to 66% of admissions.

In North America and western Europe, the authors report a figure of under 15% to 30%.

The sickest patients, the longest stays

Half of those admitted with advanced HIV illnesses stayed 14 days or more, while half of the other patients stayed 6 days or more.

About 11 in 100 of them needed intensive care, compared with about 4 in 100 of the others.

Nearly 9 in 100 died within 30 days, compared with fewer than 3 in 100.

Across all patients, 4.8% died within 30 days.

The authors describe that as the lower end of what has been reported in previous Colombian studies and link it to the resources of a large referral hospital.

Tuberculosis steps to the front

Among advanced HIV illnesses, tuberculosis was the most common cause over the whole period.

Its share of these illnesses rose from 12.5% before the pandemic to 27.3% afterwards, making it the leading cause in that period.

Kaposi sarcoma, a cancer linked to HIV, rose from 11.8% to 16.4% of these illnesses and became the second most common.

These are shares, so they do not show whether more patients actually had tuberculosis.

The authors say the tuberculosis rise is consistent with a rebound in detection and reporting after COVID-19 disrupted health services.

They also point to national guidance favouring newer, more sensitive tests, which find more cases.

The study cannot show which of these explains the increase.

Mental health admissions edge up

Mental health conditions were the main reason for 2.4% of admissions before the pandemic and 5.5% afterwards.

The numbers are small, with 28 such admissions across the whole study.

The authors say the rise deserves attention because mental health, drug use and sticking to treatment can each affect the others.

Smoking and inhaled drug use also became more common among those admitted.

Treatment taken, virus not always controlled

About seven in ten admissions involved people who had already used HIV medicines.

Even so, more than half arrived with the virus still detectable in their blood, a sign it was not fully under control.

Among those with a treatment history, nearly three in ten had gaps in taking their medicines recorded in their files, based on what patients told clinicians.

The authors say this points to continuing problems with taking, reaching or staying on treatment.

About one in seven admissions were new HIV diagnoses, and about six in ten were classed as the most advanced stage of infection.

The authors point to late diagnosis as a likely contributor.

What one hospital can and cannot show

The study covers a single hospital and relied on past medical records.

Because it is a referral centre, it likely sees sicker patients than smaller hospitals, which may overstate how common and how severe advanced HIV illnesses are.

How closely patients took their medicines, and their drug use, were mostly based on what patients told staff.

The three periods were set by calendar dates, so the authors say the role of the pandemic cannot be separated from other changes, such as insurance rules, service changes and better outpatient care.

The authors reported no specific funding and no competing interests.

The authors concluded that earlier diagnosis, active searching for cases, tuberculosis prevention, mental health care and keeping patients in treatment are needed, while noting that their findings come from one hospital and do not describe HIV care across Colombia.

Source:Rico-Bolívar DL, et al. PLoS One. 2026;21(9):e0357788. doi:10.1371/journal.pone.0357788