Epidemiological Profile of Deaths in Patients Living With Hiv/AIds in a Referral Hospital in the Year 2023

To describe the epidemiological profile of patients living with HIV/AIDS (PLHIV) who progressed to death in a referral hospital for infectious diseases, in the year 2023, according to the mortality review committee’s analysis. Variables such as sex, age, time of HIV infection, last CD4 T-lymphocyte values and HIV viral load, adherence to antiretroviral therapy (ART), site of outpatient follow-up, and the main pathologies recorded on the Death Certificate were evaluated. Of the 140 deaths that occurred at the institution in 2023, 100 patients (71.4%) lived with HIV/AIDS, most being male (66%) and with a mean age of 47 years. Regarding HIV infection, 24% of deaths were of patients diagnosed less than 30 days before hospitalization, while 76% had a previous diagnosis, with 51.4% lacking regular adherence to ART. Among patients with recent HIV diagnosis (n = 24), mean age was 38.9 years, 75% were male, and the mean CD4 T-lymphocyte count was 78 cells/mm³. Sepsis/septic shock and its complications were the immediate cause of death in 75% of these cases, with respiratory infections accounting for 50% of etiologies. The most prevalent pathologies in newly diagnosed advanced AIDS included tuberculosis (29%), cytomegalovirus disease (20.8%), pneumocystosis (16.6%), Kaposi’s sarcoma (12.5%), cryptococcosis of the central nervous system (12.5%), and toxoplasma meningoencephalitis (8.3%). In patients with pre-existing HIV diagnosis (n = 76), mean age was 49.5 years, 60.5% were male, and the mean CD4 T-lymphocyte count was 183 cells/mm³. Only 44.7% had undetectable viral load (< 50 copies). The main death diagnoses were bacterial infections and their complications (25%), followed by Mycobacterium tuberculosis diseases (22.3%) and neoplasms (18.4%). As for the place of treatment, 30.2% were followed up at the referral hospital’s outpatient clinic and 69.8% in external services. The analysis of deaths in PLHIV underscores the ongoing importance of studying these events as a crucial part of patient care and the care continuum. The data show that a large proportion of deaths still occur in young patients, newly diagnosed with advanced AIDS or with poor adherence to treatment.