Causes of lethal outcomes among HIV-positive individuals and the life expectancy of patients in the presence and absence of concomitant tuberculosis in the Perm region
The objective. To study causes of lethal outcomes among HIV-positive individuals and the life expectancy of patients in the presence and absence of concomitant tuberculosis in the Perm region. Materials and methods. We have assessed causes of death of 2721 HIV-positive individuals according to materials of the Perm region in 1998-2013. We have analyzed case records (f. No 25), postmortem reports, medico-legal reports (f. No 170/u), pathology reports (f. No 013/u). Results. As has been found, 31.6% of patients died of external causes, 30.1% - of causes directly related to HIV infection, 32.1% - of diseases of various organs and systems possibly related to HIV infection. In 6.2% of cases, death causes have not been established. Among deaths from causes directly related to HIV infection, 71.4% of individuals had tuberculosis. A significant statistical relation has been found between the death of HIV-positive individuals of causes directly related to infection and of diseases of various organs and systems possibly related to HIV infection, on the one hand, and the incidence of HIV infection, on the other, which is especially marked in the morbidity - mortality shift to the left by 5 years. Conclusion. The mean life span of HIV-positive individuals, who died directly of HIV infection, was in case of monoinfection 6.8 ± 0.3 years, in concomitant tuberculosis - 5.0 ± 0.3 years. Prevention of tuberculosis among HIV-positive individuals might be regarded as one of the most significant measures aimed at increasing the life expectancy of patients.