Mortality rate and causes of death among HIV patients at Bach Mai Hospital: A retrospective analysis from 2009-2018

 https://doi.org/10.52322/jocmbmh.07.en.10

ABSTRACT

Introduction: Despite the availability of efficient antiretroviral treatments in the early years of the HIV epidemic, a significant excess mortality in HIV-infected individuals was nevertheless reported in Vietnam.

Objectives: To report recent changes in mortality and causes of death in a hospital-based cohort of HIV-positive individuals under ART in Vietnam at Bach Mai Hospital for nearly 10 years from 2009 to 2018.

Material and Methods: We conducted a retrospective observation cohort from 2009 to 2018 among HIV/AIDS patients enrolled to ARV treatment at Bach Mai Hospital. Patients were selected if they were confirmed dead during the 2009-2018 period at the HIV outpatient clinic.

Results: From 2010 to 2018, the mortality rate gradually decreased over the years, from 72.2 /1000 person-years in 2010 to 22.1 deaths/1000 person-years in 2018. Mortality rate due to AIDS-related causes was higher than mortality from non-AIDS causes in all years. Among 219 death patients, AIDS-related still account for the majority of 60.9% deaths. Liver disease, including hepatitis B, C, liver cancer ranked as second place (10.9%), and followed by non-AIDS-related cancers (7.7%), non-AIDS infections (5.9%), accidents (5.0%), drug-induced anaphylactic shock (1.4%), cardiovascular disease (0.9%) and suicide (0.5%). Tuberculosis, wasting syndrome, PCP pneumonia and Toxoplasmosis were the main causes of AIDS-related death. The time to die from these causes was mainly within 6 months of HIV diagnosis.

Conclusion: The mortality rate among HIV/AIDS patients enrolled at Bach Mai Hospital has been reduced significantly from 2009 to 2018. Optimal HIV management and chronic comorbidities treatment services were recommended for HIV/AIDS patients in Vietnam.

Keywords: Mortality, causes of death, HIV, AIDS, antiretroviral therapy, ART, ARV, Vietnam.

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