艾滋病毒感染者的死因：来自斯威士兰五家医疗机构的经验教训。

Causes of death in people living with HIV: Lessons from five health facilities in Eswatini.

作者信息

Mafulu Yves, Khumalo Sukoluhle, Williams Victor, Ndabezitha Sandile, Nyandoro Elisha, Ndlovu Nkosana, Kay Alexander, Maseko Khetsiwe, Simelane Hlobsile, Gwebu Siphesihle, Musarapasi Normusa, Mafukidze Arnold, Bongomin Pido, Dube Nduduzo, Buzaalirwa Lydia, Dube Nkululeko, Haumba Samson

机构信息

Department of Care and Treatment, AIDS Healthcare Foundation, Manzini, Eswatini.

Center for Global Health Practice and Impact, Georgetown University, Mbabane, Eswatini.

出版信息

South Afr J HIV Med. 2024 Oct 28;25(1):1614. doi: 10.4102/sajhivmed.v25i1.1614. eCollection 2024.

DOI:10.4102/sajhivmed.v25i1.1614

PMID:39507464

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11538099/

Abstract

BACKGROUND

Eswatini has a high HIV prevalence in adults and, despite being one of the first countries to achieve the UNAIDS 95-95-95 targets, AIDS-related deaths are still high.

OBJECTIVES

This study describes the causes of death among people living with HIV (PLHIV) receiving care at five clinics in Eswatini.

METHOD

A cross-sectional review of sociodemographic, clinical and mortality data of deceased clients who received care from 01 January 2021 to 30 June 2022, was conducted. Data were extracted from the deceased clients' clinical records, and descriptive and comparative analysis was performed.

RESULTS

Of 257 clients, 52.5% ( = 135) were male, and the median age was 47 years (interquartile range [IQR]: 38, 59). The leading causes of death were non-communicable diseases (NCDs) ( = 59, 23.0%), malignancies ( = 37, 14.4%), COVID-19 ( = 36, 14.0%), and advanced HIV disease (AHD) ( = 24, 9.3%). Clients who had been on antiretroviral therapy (ART) for 12-60 months (OR: 0.01; 95% confidence interval [CI]: 0.0006, 0.06) and > 60 months (OR: 0.006; 95% CI: 0.0003, 0.029) had lower odds of death from AHD compared to those on ART for < 12 months. Clients aged ≥ 40 years had higher odds of dying from COVID-19, while female clients (OR: 2.64; 95% CI: 1.29, 5.70) had higher odds of death from malignancy.

CONCLUSION

Most clients who died were aged 40 years and above and died from NCD-related causes, indicating a need to integrate prevention, screening, and treatment of NCDs into HIV services. Specific interventions targeting younger PLHIV will limit their risk for AHD.

摘要

背景

斯威士兰成年人中的艾滋病毒流行率很高，尽管该国是最早实现联合国艾滋病规划署95-95-95目标的国家之一，但与艾滋病相关的死亡人数仍然很高。

目的

本研究描述了在斯威士兰五家诊所接受治疗的艾滋病毒感染者（PLHIV）的死亡原因。

方法

对2021年1月1日至2022年6月30日期间接受治疗的已故患者的社会人口统计学、临床和死亡率数据进行横断面回顾。数据从已故患者的临床记录中提取，并进行描述性和比较性分析。

结果

在257名患者中，52.5%（=135）为男性，中位年龄为47岁（四分位间距[IQR]：38，59）。主要死亡原因是非传染性疾病（NCDs）（=59，23.0%）、恶性肿瘤（=37，14.4%）、COVID-19（=36，14.0%）和晚期艾滋病毒疾病（AHD）（=24，9.3%）。接受抗逆转录病毒治疗（ART）12-60个月（OR：0.01；95%置信区间[CI]：0.0006，0.06）和>60个月（OR：0.006；95%CI：0.0003，0.029）的患者死于AHD的几率低于接受ART<12个月的患者。年龄≥40岁的患者死于COVID-19的几率更高，而女性患者（OR：2.64；95%CI：1.29，5.70）死于恶性肿瘤的几率更高。