Causes of Death in Hospitalized HIV Patients in the Early Anti-Retroviral Therapy Era.
OBJECTIVE
To establish the cause(s) of death among persons with HIV and AIDS admitted to the Fevers Unit of the Korle-Bu Teaching Hospital (KBTH) in 2007 and to determine whether they were AIDS-related in the era of availability of HAART.


METHODS
Retrospective chart review of all deaths that occurred in the year 2007 among inpatients with HIV infection. Cause of Death (COD) was established with post mortem diagnosis, where not available ICD-10 was reviewed independently by two physicians experienced in HIV medicine and a consensus reached as to the most likely COD.


RESULTS
In the year under review, 215 (97%) of the 221 adult deaths studied were caused by AIDS and HIV-associated illnesses. Of these, 123 (55.7%) were due to an AIDS-defining illness as described in CDC Category 3 or WHO stage 4. Infections accounted for most of the deaths 158 (71.5%), many of them opportunistic 82 (51.8%). Tuberculosis was the commonest COD. Clinical diagnosis of TB was accurate in 54% of deaths, but was not validated by autopsy in 36% of deaths. There were few deaths (14.5%) in patients on HAART.


CONCLUSIONS
In a developing country like Ghana where HAART was still not fully accessible, AIDS-related events remained the major causes of death in persons living with HIV. Total scale-up of the ART programme with continuous availability of antiretrovirals is therefore imperative to reduce deaths from AIDS and HIV associated illnesses. There is need for interventions for early diagnosis as well as reduction in late presentation and also better diagnostic tools for tuberculosis.
Department of Medicine, University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra, Ghana ; Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana.
M
M
Lartey
International Organization for Migration, Accra, Ghana.
A
A
Asante-Quashie
Department of Community Health, University of Ghana Medical School, Korle Bu.
A
A
Essel
Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana.
E
E
Kenu
Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana.
V
V
Ganu
Department of Medicine, University of Ghana Medical School, College of Health Sciences, Korle Bu, Accra, Ghana ; Department of Medicine, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana.
A
A
Neequaye
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023241:Antiretroviral Therapy, Highly Active / Q000401:mortality*; D002423:Cause of Death; D005260:Female; D005869:Ghana / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014397:Tuberculosis, Pulmonary / Q000401:mortality; D055815:Young Adult
AIDS; Cause of death; Ghana; HAART; HIV; Tuberculosis