In-hospital Mortality and Causes of Death in People Diagnosed With HIV in a General Hospital in Shenyang, China: A Cross-Sectional Study.

Cheng Bo Li,Yu Wang,Ying Zhou,Sheng Liu,Qing-Hai Hu,Wen Wang,Pei Liu,Cui Ming Sun,Xu Lu,Ying Wen

doi:10.3389/fpubh.2021.774614

Cheng Bo Li, Yu Wang + Show 8 more

Open Access

https://doi.org/10.3389/fpubh.2021.774614

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Abstract

Background: Acquired immune deficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV) infection, is a serious public health issue. This study investigated the correlated factors and possible changing trend of in-hospital death in patients diagnosed with HIV in the past decade in our hospital.Methods: We retrospectively collected data of firstly hospitalized patients with HIV in the Department of Infectious Disease in the First Affiliated Hospital of China Medical University from January 1, 2010 to December 31, 2019, and compared various factors that correlated with in-hospital death, including age, sex, opportunistic infections, and antiretroviral therapy (ART) status. Cox regression analysis was used to identify the risk factors for death.Results: In total, 711 patients were recruited for this study, and 62 patients died in the hospital. The in-hospital mortality rate was 8.72%. Tuberculosis (TB), malignancies, and thrombocytopenia were associated with mortality. Antiviral treatment before admission was found to be a protective factor. There was a declining trend in in-hospital mortality from 19.2% in 2010 to 6.3% in 2019 (linear-by-linear association test, p < 0.001), partly due to intensified medical care strategy.Conclusions: Till date, AIDS-defining illnesses remain the major cause of hospital admission and in-hospital mortality. TB and malignancies were correlated risk factors for in-hospital mortality. ART before admission was found to be beneficial, and considering the decreasing rate of in-hospital mortality, the implementation of intensified medical care strategy requires further effort.

Highlights

Acquired immune deficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV) infection, is a serious public health problem, being the sixth most common cause of mortality worldwide [1]
HIV was sexually transmitted in 653 patients (91.8%), and 412 patients were men who have sex with men (MSM)
The causes of hospital admission in 532 cases (74.8%) were AIDS-related illnesses, in other words being at World Health Organization (WHO) clinical stage III–IV, including candidiasis, pneumocystis jiroveci pneumonia (PJP),TB, central nervous system (CNS) infection, invasive fungal disease, cytomegalovirus (CMV) retinitis, malignancies, bacterial bloodstream infection, and disseminated Mycobacterium avium complex disease

Summary

Introduction

Acquired immune deficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV) infection, is a serious public health problem, being the sixth most common cause of mortality worldwide [1]. CD4+T lymphocytes destruction leads to severe immune deficiency, which causes various opportunistic infections and malignant tumors. Late diagnosis and late treatment lead to high morbidity and mortality rates. With the employment of effective antiretroviral therapy (ART) and an updated strategy of ART initiation, AIDS-defining deaths have reduced significantly. Non-AIDS-related mortality rate is increasing among well-virologically controlled populations living with HIV, especially in persons with previous AIDS-defining events [2, 3]. Acquired immune deficiency syndrome (AIDS), caused by human immunodeficiency virus (HIV) infection, is a serious public health issue. This study investigated the correlated factors and possible changing trend of in-hospital death in patients diagnosed with HIV in the past decade in our hospital

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