Disease patterns and causes of death of hospitalized HIV‐positive adults in West Africa: a multicountry survey in the antiretroviral treatment era

• DOI: 10.7448/ias.17.1.18797
• Publication Date: 2014-04-07T07:40:43Z
• Authors: Charlotte Lewden; Youssoufou J Drabo; Djimon M Zannou; Moussa Y Maiga; Daouda K Minta; Papa S Sow; Jocelyn Akakpo; François Dabis; Serge P Eholié
• Keywords: Antiretroviral treatment

We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized West Africa.We conducted a six-month prospective multicentre survey within IeDEA Africa collaboration six adult medical wards of teaching hospitals Abidjan, Ouagadougou, Cotonou, Dakar Bamako. From April October 2010, all newly patients were eligible. Baseline follow-up information until hospital discharge was recorded using standardized forms. Diagnoses reviewed by local event validation committee reference definitions. Factors associated with in-hospital studied logistic regression model.Among 823 (median age 40 years, 58% women), 24% discovered their HIV infection during hospitalization, median CD4 count 75/mm(3) (IQR: 25-177) 48% had previously received antiretroviral treatment (ART). The underlying causes hospitalization AIDS-defining conditions (54%), other infections (32%), diseases (8%) non-specific illness (6%). most frequent diagnosed were: tuberculosis (29%), pneumonia (15%), malaria (10%) cerebral toxoplasmosis (10%). Overall, 315 (38%) died cause death AIDS (63%), non-AIDS-defining (26%), (7%) or unknown (4%). Among them, fatal (36%), (10%), cryptococcosis (9%) sepsis (7%). Older age, clinical WHO stage 3 4, low count, infectious diagnoses fatality.AIDS-defining conditions, primarily tuberculosis, bacterial resulted high fatality. Sustained efforts are needed integrate care these disease optimize earlier diagnosis initiation ART.