Causes of Death Shift Over Time
What's New, from the 8th Conference on Retroviruses and Opportunistic Infections
March 16, 2001
The wider availability of protease inhibitors in North America and Western Europe has led to a dramatic fall in AIDS-related deaths. Yet, highly active antiretroviral therapy (HAART) is not a cure; and some people with HIV/AIDS (PHAs), particularly those with low incomes, are more likely to die than others. To find out if causes of death in people with AIDS (PWAs) have changed since HAART became available in 1996, researchers in different parts of the world are conducting studies. Here's one report from a U.S. hospital, Cook County Hospital in Chicago, which serves a low-income population.
Researchers at this hospital reviewed medical records of 98 people with AIDS who died at that institution between January 1998 and September 2000. Overall, about 3% of PWAs died in the year 2000 compared with a 5% death rate among PWAs in 1995. HAART was largely unavailable in 1995.
The profile of the 98 subjects at the time they entered the hospital is as follows:
According to the researchers, subjects who were hospitalized with life-threatening infections were likely to have the following profile:
The most common causes of death for patients hospitalized for infections were caused by complications from cancer or lung problems. While we're not going to list the cause of all 98 deaths here, commonly seen AIDS-related infections included:
Commonly seen cancers that led to death included:
Other causes of death included the following:
According to the researchers, as many as 38% of subjects did not have life-threatening infections and were dying of complications due to severe liver and kidney damage as well as bacterial infections. The same group of doctors who did this study conducted an earlier study at a nearby prestigious private hospital, Rush-Presbyterian St. Luke's Medical Center, and found that death rates among HIV positive patients were lower there than seen at the hospital that treated low income PHAs. While HAART is clearly beneficial, PWAs with low incomes are more likely to die than those with higher incomes. While the results from this study may seem obvious, health policy planners need to keep them in mind when allocating resources to the health care and social services sectors.
This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.