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Non-AIDS In-Hospital Deaths Up in HIV-Infected Patients

Non-AIDS infections and cardiovascular disease are common causes of mortality in the ART era

WEDNESDAY, July 8, 2015 (HealthDay News) — Trends in hospital deaths among HIV-infected patients show that mortality during the antiretroviral therapy (ART) era is often caused by diseases and conditions other than AIDS. The findings were published online June 30 in the Journal of Hospital Medicine.

Annie Cowell, M.D., of the University of California in San Diego, and colleagues reviewed the medical records of HIV-infected patients who died at an urban teaching hospital from 1995 through 2011. The authors sought to assess causes of death and factors associated with mortality.

The researchers found that in-hospital deaths among HIV-infected patients declined significantly, and deaths that were not attributable to AIDS increased from 43.0 to 70.5 percent. The most common causes of non-AIDS deaths were non-AIDS infection (20.3 percent), cardiovascular conditions (11.3 percent), liver disease (8.5 percent), and non-AIDS malignancy (7.8 percent). Patient factors significantly associated with non-AIDS deaths versus AIDS-related deaths included older age (median age, 48 versus 40 years), more likely to be on ART (74.1 versus 55.8 percent), less likely to have a CD4 count of <200 cells/mm³ (47.2 versus 97.1 percent), and more likely to have an HIV viral load of ≤400 copies/mL (38.1 versus 4.1 percent).

“Physicians caring for hospitalized patients should appreciate the current trends in the HIV epidemic to provide comprehensive and appropriate interventions that can reduce mortality for HIV-infected inpatients,” the authors write.

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