AEGiS-11IAC: Causes of death in an HIV natural history cohort in rural Uganda.

11th International AIDS Conference


Vancouver, British Columbia — July 7-12, 1996

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Causes of death in an HIV natural history cohort in rural Uganda.

Int Conf AIDS 1996 Jul 7-12; 11:448 (abstract no. Pub.B.1063)
Okongo M, Morgan D, Mayanja B, Malamba S, Babuwe J, Whitworth J; Medical Research Council Programme on AIDS/Uganda Virus Research Institute, Entebbe, Uganda. Fax: +256 42 21137. E-mail: mrc@mukla.gn.apc.org.

OBJECTIVE: To determine causes of death in an HIV natural history cohort established in 1990 in Uganda.

METHODS: A total of 388 (179 HIV + ve and 209 HIV -ve) consenting adults aged 13 years and over have been recruited into the cohort from the general population and are seen every three months. At each visit detailed medical interviews, full physical examination and basic laboratory investigations are carried out. The cause of death was assessed from a combination of premorbid clinical and laboratory findings and detailed information obtained from relatives. Two clinicians independently assessed causes of death blind to HIV serostatus and in cases of disagreement a third clinician adjudicated. Postmortems were unavailable.

RESULTS: A total of 64 deaths occurred up to December 1995. 54 were HIV-positive, and 10 negative controls (30.2% and 4.8% respectively of those enrolled). Causes of death could not be ascribed for 10 cases (7 +ves and 3 -ves) due to lack of adequate information. The median age of the seropositives at death was 34 years (range 23 - 74), and that of negative controls was 53 years (range 20 - 81). The main causes of death in HIV +ves were: chronic diarrhoea, non-tuberculous chest infection, cryptococcal meningitis and disseminated Kaposi's sarcoma. All those who died of HIV related causes had weight loss greater than 10%. Two deaths were ascribed to non-HIV related causes (ruptured ectopic pregnancy and suicide), thus 95.7% percent of the HIV-seropositives were assessed as having an HIV related death. Of the HIV-negatives, apart from one person with possible TB, none died of HIV associated disease.

CONCLUSIONS: The pattern of cause of death varied according to HIV serostatus. Eighty three percent of all deaths in the cohort for which a cause could be ascribed was HIV related. The main causes of death in HIV-infected adults reflected the clinical case definition of AIDS in Africa.

Keywords: AEGIS, HIV Infections, Acquired Immunodeficiency Syndrome, HIV Seropositivity, Death, Meningitis, Cryptococcal, Uganda, Cause of Death, Double-Blind Method, Interviews, Africa, Adult, Human, Female, Pregnancy, etiology, ICA11KWDaegis,hivinfections,acquiredimmunodeficiencysyndrome,hivseropositivity,death,meningitis,cryptococcal,uganda,causeofdeath,double-blindmethod,interviews,africa,adult,human,female,pregnancy,etiology,ica11

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PubB1063

Copyright © 1996 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.