Causes and pattern of mortality in HIV-infected, hospitalized patients in a tertiary care hospital: A fourteen year study

Teja, Vijay Dharma; Sudha, Talasila; Lakshmi, V

doi:10.4103/0019-5359.35805

Cited by 14 publications

(11 citation statements)

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“…[12][13][14] The survival of PLHIV individuals and underlying associated factors with mortality depend on demographic characteristics, laboratory variables and clinical indicators. [15][16][17][18][19] A nationwide large scale household survey suggested that only 17% and 25% currently married women have heard about STIs and HIV, respectively. 20 Moreover, empirical research in India have reported conflicting trends in mortality rates; few studies reported increasing mortality trends among HIV infected individuals while another set of studies reported a decline in mortality rates over the years.…”

Section: Introductionmentioning

confidence: 99%

Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, India

Bajpai¹,

Chaturvedi

Kumar

et al. 2016

Int J Community Med Public Health

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Background: Antiretroviral treatment (ART) consistently improved survival of people living with HIV and contributes to prevent new infections. In this study, we estimated the lifetime survival and examined the associated correlates of mortality amongst HIV-patients registered during 2007-11 in Andhra Pradesh, India. Methods: A total 63,882 adult HIV/AIDS cases (≥15 years) with complete follow-up information were extracted from ART database and included in the analysis. The Kaplan-Meier method was used to estimate the survival and Cox PH model was used to determine the relative hazard of mortality. Results: Nearly twelve percent (11.9%) of the total cases them (n=7,621) died during the follow-up period. Overall lifetime survival was estimated to 12.2 (95% C.I. 12.0-12.3) years. Multivariable Cox proportional hazard model indicated the mortality was significantly associated with age, CD4 count, gender, clinical stage and functional status. Conclusions: The scale-up of ART has resulted in substantial reductions in mortality and increased survival. Such information is useful for institution of intervention measures to reduce risk of death.

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Section: Introductionmentioning

confidence: 99%

Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, India

Bajpai¹,

Chaturvedi

Kumar

et al. 2016

Int J Community Med Public Health

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“…Available data come mainly from research protocols, clinical trials or specifically designed cohort studies, which may differ from routine programs by the selection of the population and by the means engaged to diagnose clinical events. Moreover, most available data concerning hospitalizations come from retrospective studies [18–22]. …”

Section: Introductionmentioning

confidence: 99%

Disease patterns and causes of death of hospitalized HIV‐positive adults in West Africa: a multicountry survey in the antiretroviral treatment era

Lewden

Drabo

Zannou

et al. 2014

Journal of the International AIDS Society

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ObjectiveWe aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa.MethodWe conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms. Diagnoses were reviewed by a local event validation committee using reference definitions. Factors associated with in-hospital mortality were studied with a logistic regression model.ResultsAmong 823 hospitalized HIV-positive adults (median age 40 years, 58% women), 24% discovered their HIV infection during the hospitalization, median CD4 count was 75/mm3 (IQR: 25–177) and 48% had previously received antiretroviral treatment (ART). The underlying causes of hospitalization were AIDS-defining conditions (54%), other infections (32%), other diseases (8%) and non-specific illness (6%). The most frequent diseases diagnosed were: tuberculosis (29%), pneumonia (15%), malaria (10%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non-AIDS-defining infections (26%), other diseases (7%) and non-specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality.ConclusionsAIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most frequent causes of hospitalization in HIV-positive adults in West Africa and resulted in high in-hospital fatality. Sustained efforts are needed to integrate care of these disease conditions and optimize earlier diagnosis of HIV infection and initiation of ART.

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“…A study from southern India reported the decrease in mortality from 25 to 5 deaths per 100 person years among HIV infected individuals between 1997 and 2003 after initiation of ART [7]. A retrospective study from Andhra Pradesh in India conducted over a 14-year period on 2050 HIV-infected patients reported more deaths in highly active antiretroviral therapies (HAART) era as compared to pre HAART era [8]. Although AIDS-related death rates have declined, the associated co-morbidities continue to gain increased attention from the national program.…”

Section: Introductionmentioning

confidence: 99%

Causes of Death among HIV-Infected Adults Registered in Selected Anti-Retroviral Therapy Centers in North-Eastern India

Bhattacharjya¹,

Sahu²,

Patel³

et al. 2015

WJA

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Background: Causes of death related studies in HIV infected population are necessary to devise disease specific preventive interventions at both state and national level HIV programs. This study examines the causes of death among HIV-infected individuals registered at selected Anti-Retroviral Therapy (ART) centers in the era of treatment in north-eastern India. Data and Methods: A retrospective chart review of causes of death was undertaken among HIV-infected patients who were treated between January 2006 and November 2012 at three selected ART centers in Assam, a north-eastern state of India. Reported causes of death were coded as per the guidelines of the International Classification of Diseases (ICD-10) to determine the deaths to standard definitions. Results: Among 5612 HIV-infected patients registered over a period of 71 months, 370 deaths have occurred. Tuberculosis (28%) was the leading cause of death followed by death due to AIDS related complex (11%), wasting syndrome and multiple infections (9% each). Deaths due to selected causes were significantly associated with patient's use of alcohol, WHO clinical stage, CD4 count at the time of diagnosis, presence of opportunistic infections during treatment and ART adherence. Median survival duration was shortest among patients who had CD4 count <50 at the start of ART (2.9 months) and patients who had multiple opportunistic infections during treatment (2.5 months). Discussion: Majority (67%) of deaths in our study were due to AIDS-related causes. Tuberculosis has remained the leading cause of death among the HIV patients on ART. Strengthening the linkages and referral between the HIV and TB program will be crucial to reduce the AIDS-related deaths attributed to tuberculosis.

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Causes and pattern of mortality in HIV-infected, hospitalized patients in a tertiary care hospital: A fourteen year study

Abstract: BACKGROUND:The introduction of highly active antiRetroviral therapy (HAART) (1992( -1996( ), 7.29% in the early HAART era (1997 and 9.73% in the present HAART era (2001HAART era ( -2005

Cited by 14 publications

References 5 publications

Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, India

Estimation of life-time survival and predictors of mortality among the people living with HIV/AIDS: a case study in Andhra Pradesh, India

Disease patterns and causes of death of hospitalized HIV‐positive adults in West Africa: a multicountry survey in the antiretroviral treatment era

Causes of Death among HIV-Infected Adults Registered in Selected Anti-Retroviral Therapy Centers in North-Eastern India

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