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

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. 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. 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 non HIV-related. 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.