3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 23-26 October 2001, Athens, Greece

Changes in the spectrum of death causes among HIV-infected patients during 1996-1999

Antiviral Therapy 2001; 6(Suppl. 4):25 (abstract no. 31)

B Åkerlund¹, A Karlsson², C Håkangård³, K Koppel² and L Morfeldt⁴ on behalf of The HivBivus Collaborative Group
¹Huddinge University Hospital, Huddinge, Sweden; ²Stockholm Söder Hospital, Stockholm, Sweden; ³Malmö University Hospital, Malmö, Sweden; and ⁴Karolinska University Hospital, Sweden

BACKGROUND: Following the introduction of combination antiretroviral therapy (ART)in Sweden in 1996, a dramatic decrease in mortality has been observed.

OBJECTIVE: To study the spectrum of death causes among HIV-infected patients in Sweden during 1996-1999, with special regard to any increase in drug-associated fatal outcomes.

DESIGN: A retrospective study of all fatal cases at the four largest HIV-units 'of Sweden. Information was gained from patient charts according to a standardized protocol focusing on; cause of death, immune function/ AIDS diagnoses, possible association between drugs and death, and the frequency of post-mortem examination.

RESULTS: The total number of patients cared for at the HIV-units involved increased during the study period. In spite of this, the total number of fatal cases fell from 114 to 24, and the number of 'AIDS deaths' from 77 to 9, in 1996 and 1999, respectively. The autopsy frequency was low during the whole period, around 30%. Despite the lack of information in this retrospective study, several cases of death were found or suspected to be associated with the antiretroviral therapy.

CONCLUSIONS: Following the introduction of effective ART there has been a great reduction in the rate of 'AIDS deaths'. However, in a substantial number of patients who died there was no severe immunodeficiency and in several of these cases ART may have caused or contributed to death. Accordingly, further surveillance with regard to drug associated fatal outcomes, as well as an increased frequency of post-mortem examination, are warranted.

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