title: [Causes of death in patients with HIV infection in two Tunisian medical centers].
abstract: Antiretroviral tritherapy has contributed to a considerable reduction in HIV-related mortality. The causes of death are dominated by opportunistic infections in developing countries and by cardiovascular diseases and cancer in developed countries. To determine the causes and risk factors associated with death in HIV-infected patients in two Tunisian medical centers. cross-sectional study of HIV-infected patients over 15 years treated at Sousse and Monastir medical centers between 2000 and 2014. Death was considered related to HIV if its primary cause was AIDS-defining illness or if it was due to an opportunistic infection of unknown etiology with CD4 < 50 cells/mm3; it was considered unrelated to HIV if its primary cause wasn't an AIDS defining illness or if it was due to an unknown cause if no information was available. Two hundred thirteen patients, 130 men (61%) and 83 women (39%), average age 40 ± 11 years were enrolled in the study. Fifty four patients died, the mortality rate was 5.4/100 patients/year. Annual mortality rate decreased from 5.8% in 2000-2003 to 2.3% in 2012-2014. Survival was 72% at 5 years and 67% at 10 years. Death events were associated with HIV in 70.4% of cases. The leading causes of death were pneumocystis carinii pneumonia and cryptococcal meningitis in 6 cases (11%) each. Mortality risk factors were a personal history of opportunistic infections, duration of antiretroviral therapy < 12 months and smoking. Strengthening screening, early initiation of antiretroviral therapy and fight against tobacco are needed to reduce mortality in patients infected with HIV in Tunisia.
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Jihène
authors.initials: J
authors.lastname: Chelli
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Foued
authors.initials: F
authors.lastname: Bellazreg
authors.affiliation: Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie.
authors.forename: Abir
authors.initials: A
authors.lastname: Aouem
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Zouhour
authors.initials: Z
authors.lastname: Hattab
authors.affiliation: Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie.
authors.forename: Hèla
authors.initials: H
authors.lastname: Mesmia
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Nadia Ben
authors.initials: NB
authors.lastname: Lasfar
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Wissem
authors.initials: W
authors.lastname: Hachfi
authors.affiliation: Service de Médecine Légale, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Tasnim
authors.initials: T
authors.lastname: Masmoudi
authors.affiliation: Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chakroun
authors.affiliation: Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie.
authors.forename: Amel
authors.initials: A
authors.lastname: Letaief
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000401:mortality; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D018791:CD4 Lymphocyte Count; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000453:epidemiology / Q000401:mortality; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000453:epidemiology / Q000401:mortality; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D014416:Tunisia / Q000453:epidemiology
keywords: Causes of death; HIV; Tunisia; opportunistic infections; risk factors