The advent of antiretroviral therapy has significantly improved AIDS-related morbidity and mortality. Yet, among people living with HIV, deaths due to non-AIDS-defining illnesses have been on the rise. The objective of this study was to provide information about the global prevalence and distribution of non-AIDS causes of death in the last ten years among people living with HIV receiving antiretroviral therapy, by income levels of countries. We used broad search terms in Google Scholar, PubMed, and EMBASE to identify all studies that investigated the cause of death among people living with HIV receiving antiretroviral therapy, published after January 1, 2005. References were also identified from review articles and reference lists. Inclusion criteria were English language, the study's end date was after 2005, all patients were HIV-positive, at least two-thirds of the patients were receiving antiretroviral therapy, at least one patient died of non-AIDS causes of death. Titles, abstracts, and articles were reviewed by at least two independent readers. Of 2951 titles identified in our original search, 151 articles were selected for further screening. We identified 19 studies meeting our full criteria, with patients from 55 different nations. Pooled non-AIDS causes of death prevalence estimates in high-income countries were 53.0% (95% confidence interval, 43.6-62.3), in developing countries 34.0% (95% confidence interval, 20.3-49.1), and in sub-Saharan countries 18.5% (95% confidence interval, 13.8-23.7). Statistically significant variation was noted within and between categories. Our findings show that a significant number of people living with HIV across the world die from cardiovascular disease, non-AIDS malignancies, and liver disease. There is a global need for further scrutiny in all regions to improve preventive measures and early detection according to distinct causes of death patterns.

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This is a case report of foreign body ingestion in a 55-year-old intellectually disabled man with a history of pica and previous removal of ten plastic gloves from his rectum four months prior to this presentation. The patient presented after ingesting plastic gloves which formed large, rigid esophageal and gastric bezoars that were not amenable to endoscopic removal. An exploratory laparotomy and gastrostomy was performed, and a 10 × 4.5 × 2 cm gastric bezoar consisting of rigid plastic gloves was removed without complication. Special considerations must be taken when considering the ingestion of nonfood items in the intellectually disabled population as these cases may not present classically with symptoms of a gastric bezoar.

Background: Postpartum hemorrhage (PPH) is a major public health problem which affects a significant number of women worldwide and contributes to global maternal morbidity and mortality. Anemia in pregnancy has been shown to correlate strongly with blood loss at delivery. The purpose of this study was to investigate the association between anemia and postpartum hemorrhage (PPH) in an HIV endemic population. Methods: A retrospective chart review of pregnant women delivering at two district hospitals in semi-urban KwaZulu Natal, South Africa between January 1, 2013 and December 31, 2013 was conducted. HIV status, antenatal hemoglobin, estimated blood loss and presence or absence of a PPH was obtained. Findings: Four hundred and seventy-three charts were reviewed. Postpartum hemorrhage occurred in 35 women (7.4%). One hundred ninety-three women (40.8%) were anemic (Hb <10). One hundred sixty-seven women (36.5%) were HIV positive. Of those with PPH, 54.5% were HIV positive and 51% were anemic. Interpretation: The prevalence of anemia among women delivering at two semi-urban district hospitals in KwaZulu-Natal, South Africa is high. Anemia in HIV positive pregnant women is a risk factor for postpartum hemorrhage in the study population. Further investigation is needed to determine how best to treat anemia in HIV positive pregnant women to decrease hemorrhage-associated maternal morbidity and mortality.