title: Characteristics and predictors of death among hospitalized HIV-infected patients in a low HIV prevalence country: Bangladesh.
abstract: BACKGROUND
  Predictors of death in hospitalized HIV-infected patients have not been previously reported in Bangladesh.
  
  
  OBJECTIVE
  The primary aim of this study was to determine predictors of death among hospitalized HIV-infected patients at a large urban hospital in Bangladesh.
  
  
  METHODS
  A study was conducted in the HIV in-patient unit (Jagori Ward) of icddr,b's Dhaka Hospital. Characteristics of patients who died during hospitalization were compared to those of patients discharged from the ward. Bivariate analysis was performed to determine associations between potential risk factors and death. Multivariable logistic regression was used to identify factors independently associated with death.
  
  
  RESULTS
  Of 293 patients admitted to the Jagori Ward, 57 died during hospitalization. Most hospitalized patients (67%) were male and the median age was 35 (interquartile range: 2-65) years. Overall, 153 (52%) patients were diagnosed with HIV within 6 months of hospitalization. The most common presumptive opportunistic infections (OIs) identified were tuberculosis (32%), oesophageal candidiasis (9%), Pneumocystis jirovecii pneumonia (PJP) (8%), and histoplasmosis (7%). On multivariable analysis, independent predictors of mortality were CD4 count ≤200 cells/mm3 (adjusted odds ratio [aOR]: 16.6, 95% confidence interval [CI]: 3.7-74.4), PJP (aOR: 18.5, 95% CI: 4.68-73.3), oesophageal candidiasis (aOR: 27.5, 95% CI: 5.5-136.9), malignancy (aOR:15.2, 95% CI: 2.3-99.4), and bacteriuria (aOR:7.9, 95% CI: 1.2-50.5). Being on antiretroviral therapy prior to hospitalization (aOR: 0.2, 95% CI: 0.06-0.5) was associated with decreased mortality.
  
  
  CONCLUSIONS
  This study showed that most patients who died during hospitalization on the Jagori Ward had HIV-related illnesses which could have been averted with earlier diagnosis of HIV and proper management of OIs. It is prudent to develop a national HIV screening programme to facilitate early identification of HIV.
authors.affiliation: Dhaka hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for HIV/AIDS (CHIV), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Lubaba
authors.initials: L
authors.lastname: Shahrin
authors.affiliation: Centre for HIV/AIDS (CHIV), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Vaccine Sciences (CVS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Leung
authors.affiliation: Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.
authors.forename: Nashaba
authors.initials: N
authors.lastname: Matin
authors.affiliation: Dhaka hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for HIV/AIDS (CHIV), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Mohammed Moshtaq
authors.initials: MM
authors.lastname: Pervez
authors.affiliation: Centre for HIV/AIDS (CHIV), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Azim
authors.affiliation: Dhaka hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Pradip Kumar
authors.initials: PK
authors.lastname: Bardhan
authors.affiliation: Global Disease Detection Branch, Division of Global Health Promotion, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, United States of America.
authors.forename: James D
authors.initials: JD
authors.lastname: Heffelfinger
authors.affiliation: Dhaka hospital, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh; Centre for Nutrition and Food Security (CNFS), International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.
authors.forename: Mohammod Jobayer
authors.initials: MJ
authors.lastname: Chisti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult