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Trends and characteristics of all-cause mortality among HIV-infected inpatients during the HAART era (2006-2015) in Shanghai, China.

Trends and characteristics of all-cause mortality among HIV-infected inpatients during the HAART era (2006-2015) in Shanghai, China.
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Ji Y, Wang Z, Shen J, Chen J, Yang J, Qi T, Song W, Tang Y, Liu L, Shen Y, Zhang R, Lu H,


Ji Y, Wang Z, Shen J, Chen J, Yang J, Qi T, Song W, Tang Y, Liu L, Shen Y, Zhang R, Lu H, (click to view)

Ji Y, Wang Z, Shen J, Chen J, Yang J, Qi T, Song W, Tang Y, Liu L, Shen Y, Zhang R, Lu H,

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Bioscience trends 2017 01 3011(1) 62-68 doi 10.5582/bst.2016.01195

Abstract

Globally, the overall mortality rate among HIV-infected patients has significantly declined during the HAART era. Deaths among HIV-infected inpatients need to be characterized in order to formulate intervention strategies to further improve medical care for this population and their prognosis. In the current study, deaths among HIV-infected inpatients from 2006 to 2015 at a medical center for HIV infection and AIDS patient care in Shanghai, China were retrospectively analyzed. Trends in mortality rates and the proportion of deaths caused by AIDS or non-AIDS-related illnesses were evaluated. A bivariate analysis was performed to identify the demographic and clinical factors associated with AIDS or non-AIDS-related deaths among HIV-infected inpatients. Among 6,473 HIV-infected patients who were discharged from 2006 to 2015, 326 deaths (5.04%) were identified. The yearly mortality rate declined significantly over time (χ(2) = 34.41, p < 0.001). Results revealed that most deaths were attributed to AIDS-related illnesses (76.9 %, 233/303), and the proportion of causes of death did not change significantly over time (χ(2) = 13.847, p = 0.127). Bivariate analysis identified characteristic factors associated with AIDS-related mortality. Compared to patients who died of non-AIDS illnesses, patients who died of AIDS-related illnesses had a CD4+ T cell count lower than 50 cells/μL (OR 4.587, 2.377-8.850) and fewer liver (OR 0.391, 0.177-0.866) or renal comorbidities (OR 0.188, 0.067-0.523) on admission. Results indicated that the overall in-hospital mortality rate among HIV-infected patients has declined over the past decade. However, AIDS-related illnesses were still the major causes of deaths among HIV-infected inpatients, suggesting that further efforts are needed to improve AIDS care in China.

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