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

Background : The introduction of highly active antiRetroviral therapy (HAART) in several centers in India has raised the expectation that many human immunodeficiency virus (HIV)-infected individuals will live longer. However, as most infected individuals remain undiagnosed till the late stage of infection; several continue to succumb to this infection even in the era of HAART.
Materials and Methods : A retrospective study was conducted over a 14 year period on 2,050 HIV-infected, hospitalized patients to evaluate the pattern of mortality and to determine proportion, risk factors and causes of death.
Results : A total of 145 deaths among HIV-infected patients were documented during hospitalization, with an overall mortality rate of 8.15%: 2.94% in the pre HAART era (1992-1996), 7.29% in the early HAART era (1997-2000) and 9.73% in the present HAART era (2001-2005). 11.7% (17/145) of deceased patients were aware of their HIV-infected status before getting admitted. Only five patients were on any antiretroviral treatment prior to admission. Ninety (62.07%) deaths were HIV-related (AIDS-defining conditions) and 55 (37.93%) were nonHIV-related.
Discussion : Our study stresses the importance of early diagnosis of HIV infection to curb adult mortality, which will continue to rise unless effective treatment interventions are introduced.

Keywords
Antiretroviral, highly active antiretroviral therapy, mortality rate, World Health Organization clinical stage