Analysis Of The Specific Cause Of Death Among HIV/AIDS Patients Who Died In Seven Designated Antiretroviral Therapy Hospitals In China

Background:With combination antiretroviral therapy (cART) being increasingly available to more patients in2003, China has experienced a large decline of morbidity and mortality of Acquired Immune Deficiency Syndrome (AIDS). However, the number of deaths in human immunodeficiency virus (HIV)/AIDS patients reported in China is still increasing as more HIV infections progressing to AIDS. The specific cause of death in HIV/AIDS patients in China have not been able to be collected by the network system in the national wide because the limit of data collection system and medical level in different regions. In this study, researchers investigated the demographic and clinical characteristics of HIV/AIDS patients who died in seven designated antiretroviral therapy hospitals in China, analyzed the specific causes of death, the correlation between specific cause of death and the influencing factors, looked for their medical characteristics.Objective:To realize the specific causes of death of HIV/AIDS patients, the correlation between specific cause of death and the influencing factors, and looked for their medical characteristics.Method:Data of HIV/AIDS patients who died in seven hospitals from2009to2010were collected retrospectively, including Bejing Youan hospital, Beijing Ditan hospital, Yunnan care center, the fourth hospital in Nanning, the sixth hospital in Zhengzhou, infectious disease hospital in xinjiang. Descriptive analysis was used to analyze demographic and clinical characteristic of the deceased and their specific causes of death. Logistic regression models were used to analyze the influencing factors to the cause of death. Clinical characteristics were compared using the Pearson X2statistic for dichotomous and categorical variables.Results:381HIV/AIDS patients died in seven hospitals in2009-2010,314were male (82.4%), the priority is30-45years old.123(32.3%) death patients had received ART before death.82.1%of these patients were more than3months from HIV diagnosis to death of.258(67.7%) death patients had not received ART before death.50.8%of these patients were more than3months from HIV diagnosis to death. The priority of having received ART of Uighur death cases was the lowest. However, the priority of patients with less than3months from HIV diagnosis to death of Uighur death cases was the highest.13.1%of all the death HIV/AIDS patients were living in hospitals less than1day before death.67.2%of all the death HIV/AIDS patients were hospitalized for only one time before death.35.4%of all the death HIV/AIDS patients were in dangerous condition on hospital admission.In all death cases, the cause of death of252patients (66.1%) were due to AIDS related disease, in which, opportunistic infections was the most(92.4%). Tubercle bacillus, Penicillium marneffei and Pneumocystis jirovecy infections were the three leading causes of death in opportunistic infection deaths. Of129patients who died of non-AIDS related disease, non-AIDS infection(29.5%), liver related diseases(22.5%), and non-AIDS malignancy(10.1%) were the first three cause of death. The cause of death of patients who had injection drug use behavior within one year, had not receiving ART or received ART shorter, with opportunistic infections, with no HBV/HCV infections, with the last CD4cell count before death lower were tend to due to AIDS related disease.The rate of patients infected Tubercle bacillus in Xinjiang province was higher than other areas. Penicillium marneffei infections appears only in southern hospitals, mainly in Guangdong and Guangxi regions. Only one case in Beijing hospitals was from Guangxi (south). The proportion of the cause of death due to opportunistic infections such as Pneumocystis jirovecy and Penicillium marneffei was higher of death patients having received ART before death than not received. There are34.4%HIV/AIDS death patients co-infected with hepatitis virus before death. HCV infection was the highest one in all the hepatitis virus infections. The proportion of patients co-infected HCV or HBV/HCV was higher in ones infected HIV from injecting drug use than from other transmissions. The proportion of death due to co-infected with hepatitis virus was higher in death patients that have injected drug use within one year before death than have not.The study shows that the specific cause of death in HIV/AIDS patients is mostly due to AIDS related disease. Opportunistic infections were the most primary one, particularly infections of Tubercle bacillus, Penicillium marneffei and Pneumocystis jirovecy. Non-AIDS related infections and liver related disease were the most important cause of death of Non-AIDS related cause. The proportion of patients co-infected hepatitis was higher in ones infected HIV from injecting drug use than from other transmissions, mainly HCV infections. These types of infections must be carefully monitored in HIV patients. The duration of time a patient is on ART has impact on the patient’s cause of death, the longer time they had accessed to ART, the less likely they were to die of AIDS related illnesses.