Clinical manifestations of advanced hiv disease and causes of death among hospitalized patients in a reference center in Sao Paulo, after the introduction of highly active antiretroviral therapy -- Brazil.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. C10689)
BiancoRosana RD, Aurelio de Oliveira GoesMarco MO, YoshiokaLisa LY, NicolettiChristiane CN, Marina do Valle PereiraHaydee HM, de Souzarica ES, LeiteAntonio LA State Institution, Sao paulo, Brazil
BACKGROUND - Highly active antiretroviral therapy (HAART) has been shown to reduce morbidity and mortality associated with HIV infection in Brazil. We designed an analysis to examine patterns and reasons for hospital admissions over time and to identify demographic and clinical features that were associated with hospitalization and intensive care admission in our patients. METHODS - We retrospectively reviewed the absolute number of AIDS related deaths. All adult inpatient hospitalizations of 301 HIV positive patients enrolled in on our AIDS Reference Center Clinic between January 2000 and September 2001. RESULTS - Of a total of 301 HIV infected hospitalizations, 93 death were analyzed. The disease progress was mostly observed during the last 5 years. Of the 93 who died of AIDS, 78.4% were probably using highly active anti retroviral therapy but 46% didn't have compliance. The most common HIV associated death (in 43 patients) was disseminated tuberculosis (15), lung tuberculosis (04), PCP (11), histoplasmosis (04), MOTT (04), criptococcal meningitis (04), cerebral toxoplasmosis (03), CMV (02). HIV infected drug abusers usually carry the markers of hepatite B and C viruses. The development of opportunistic infections was shown to be dependent on the decrease of CD4 linphocytes. We designed on analyses to examine patterns and reasons for hospital admissions over time and to identify opportunistic infections and causes of death. CONCLUSIONS - These data provide a comprehensive overview of the spectrum of severe HIV disease. Tuberculosis is the most important cause of HIV related morbidity and mortality in this setting.
Keywords: AEGIS, Antiretroviral Therapy, Highly Active, HIV Infections, CD4 Lymphocyte Count, HIV Seropositivity, Acquired Immunodeficiency Syndrome, Death, Hospitalization, Tuberculosis, Pulmonary, Ambulatory Care Facilities, Brazil, Human, Adult, Mortality, Diagnosis
