Lamprecht Dirk J, Martinson Neil, Variava Ebrahim
Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
South Afr J HIV Med. 2023 Apr 26;24(1):1477. doi: 10.4102/sajhivmed.v24i1.1477. eCollection 2023.
HIV and AIDS continues to impose substantial healthcare challenges in sub-Saharan Africa, but there are limited local data comparing inpatient outcomes between people with HIV (PLWH) and those uninfected.
To compare cause-specific mortality among hospitalised adolescents and adults, stratified by HIV-serostatus.
A cross-sectional analysis was performed, analysing cause-specific inpatient mortality data and total admissions, from 01 January 2017 to 30 June 2020, at Tshepong Hospital, North West province, South Africa.
The overall inpatient mortality rate decreased from 14.5% (95% confidence interval [CI]: 13.4-16.0) in 2017, to 11.3% (95% CI: 10.6-11.9) in 2020; < 0.001. People living with HIV accounted for 53.9% ( = 2342) of inpatient deaths, 22.6% ( = 984) were HIV-seronegative patients and 23.5% ( = 1020) patients with unknown HIV-serostatus. People with HIV died at younger ages (median: 44 years, interquartile range [IQR]: 35.8-54.2) compared to HIV-seronegative inpatients (median: 64.4 years, IQR: 55.5-73.9); < 0.001. Leading causes of death were pneumonia (19.9%, = 863), then pulmonary and extrapulmonary tuberculosis (15.0%, = 654). People with HIV who had CD4+ counts < 350 cells/mL or viral load ≥ 1000 copies/mL had increased risk of death from tuberculosis compared to virally suppressed patients (adjusted relative risk: 2.10 [95% CI: 1.44-3.04, < 0.009] and 1.56 [95% CI: 1.22-2.00, < 0.001]).
Our study, conducted in a regional hospital in South Africa, showed PLWH had higher mortality rates and died at younger ages compared to HIV-seronegative patients.
在撒哈拉以南非洲地区，艾滋病毒和艾滋病仍然给医疗保健带来巨大挑战，但当地关于艾滋病毒感染者（PLWH）与未感染者住院治疗结果比较的数据有限。
比较按艾滋病毒血清学状态分层的住院青少年和成年人中特定病因的死亡率。
进行了一项横断面分析，分析了2017年1月1日至2020年6月30日期间南非西北省Tshepong医院特定病因的住院死亡率数据和总入院人数。
总体住院死亡率从2017年的14.5%（95%置信区间[CI]：13.4 - 16.0）降至2020年的11.3%（95%CI：10.6 - 11.9）；P < 0.001。艾滋病毒感染者占住院死亡人数的53.9%（n = 2342），22.6%（n = 984）为艾滋病毒血清学阴性患者，23.5%（n = 1020）为艾滋病毒血清学状态不明的患者。与艾滋病毒血清学阴性的住院患者相比，艾滋病毒感染者死亡年龄较轻（中位数：44岁，四分位间距[IQR]：35.8 - 54.2），而艾滋病毒血清学阴性住院患者的中位数为64.4岁（IQR：55.5 - 73.9）；P < 0.001。主要死亡原因是肺炎（19.9%，n = 863），其次是肺结核和肺外结核（15.0%，n = 654）。与病毒得到抑制的患者相比，CD4 + 细胞计数<350个/毫升或病毒载量≥1000拷贝/毫升的艾滋病毒感染者死于结核病的风险增加（调整后的相对风险：分别为2.10[95%CI：1.44 - 3.04，P < 0.009]和1.56[95%CI：1.22 - 2.00，P < 0.001]）。
我们在南非一家地区医院进行的研究表明，与艾滋病毒血清学阴性患者相比，艾滋病毒感染者的死亡率更高且死亡年龄更小。
