Aug 2026· World Journal of Advanced Research and Reviews· 0 citations
TL;DR
Mortality among PLHIV in this study was associated with advanced disease, opportunistic diseases, commorbidities and abnormal laboratory findings, and Strengthening early diagnosis, management of opportunistic infections, and monitoring of clinical and laboratory indicators may help reduce mortality in this population.
Abstract
Introduction: Globally and in Africa, HIV mortality is reported to have decreased over the years. Cameroon's national mortality rate was 1.7% in 2023, and there exist regional disparities and underreporting. We assessed the mortality and associated factors among People Living with HIV(PLHIV) initiated into HIV care from January 2021 to December 2023 at the Bamenda regional hospital (BRH)
Methods: A retrospective cohort study was conducted from June 2024 to December 2024 at the BRH. Using a non-probabilistic consecutive sampling technique, 331 newly initiated participants on ART were included. Data was collected from medical records using a questionnaire and analyzed using R software version 4.3.1. A multivariable Cox regression model included variables that showed statistical significance and assessed their relationship with mortality while adjusting for potential confounders. Significant predictors of mortality were identified.
Results: The mean age of participants was 41.6 ± 11.7 years, and females constituted 57.7%. Opportunistic diseases were present in 19.0% of cases, with tuberculosis (8.2%) being the most common. Key comorbidities included hypertension (8.8%), diabetes (3.9%), and hepatitis B (3.0%). Blood tests showed elevated liver enzymes (ALAT/ASAT: 41.7±23.6 U/L) and high blood sugar (144.4±7.4 mg/dL). In contrast, kidney function (Creatinine: 0.9±0.2 mg/dL) and immune cell counts (Lymphocytes: 1.8±0.7 x10³/μL) appeared normal overall. A cumulative mortality rate of 7.6% over three years (approximately 2.5% per year) was observed. Male sex (AHR=7.83, 95% CI :1.44-42.5, p=0.017), opportunistic diseases (AHR=5.66, 95% CI :1.71-18.7, p=0.004), comorbidities (AHR=6.04, 95% CI :2.02-18.1, p=0.001), Abnormal ALAT/ASAT (p=0.005), and WHO clinical stage III (AHR : 1.1, 95%CI : 1.01 -1.5, p < 0.001), were identified as predictors of mortality. Whereas BMI and ART adherence showed no significance.
Conclusion: Mortality among PLHIV in this study was associated with advanced disease, opportunistic diseases, commorbidities and abnormal laboratory findings. Strengthening early diagnosis, management of opportunistic infections, and monitoring of clinical and laboratory indicators may help reduce mortality in this population.
The incidence of LTFU among adults on ART in Guji zone was high, particularly during the first year of treatment, and targeted interventions including enhanced counseling for high-risk groups, community-based ART refill models, and active phone-based tracking systems should be implemented to improve retention.
Summary Background Advanced HIV disease (AHD) remains a major cause of hospitalization and mortality among people living with HIV (PLHIV). We evaluated the association between implementation of a structured specialist-led inpatient HIV care model and clinical outcomes among hospitalized PLHIV in southern Brazil. Methods We conducted an observational before–after study at a tertiary public hospital in Porto Alegre, Brazil, comparing a pre-intervention period (January 2023–April 2024) with a post-intervention period (May 2024–August 2025). The intervention included a dedicated infectious diseases team, standardized protocols for AHD and opportunistic infections, and rapid antiretroviral therapy (ART) initiation during hospitalization. Adults admitted with AHD were included. Adjusted risk ratios (aRR) for mortality, ICU admission, and a composite adverse outcome were estimated using modified Poisson regression. Findings A total of 963 hospitalizations among 899 unique patients were included (406 pre-intervention; 557 post-intervention). Baseline characteristics were similar between periods. In-hospital mortality declined from 24% to 17% (p = 0.014). In adjusted analyses, the post-intervention period was associated with lower risks of in-hospital mortality (aRR 0.74, 95% CI 0.57–0.96), ICU admission (0.70, 0.57–0.86), and composite adverse outcomes (0.78, 0.67–0.92). Opportunistic infection screening increased, lumbar puncture was performed more frequently, and ART was initiated earlier. Interpretation Implementation of a structured inpatient HIV care model was associated with improved clinical outcomes among PLHIV with AHD. Structured multidisciplinary inpatient HIV care may represent a promising approach to strengthen delivery of WHO-recommended AHD care in hospital settings and warrants further evaluation in controlled studies. Funding Pan American Health Organization (PAHO), US Centers for Disease Control and Prevention (CDC), and Unitaid.
P. M. Fonseca, Andressa Noal, Gisele O. Boff et al.· The Lancet Regional Health -...· 0 citations
Dyslipidemia was prevalent among approximately two in three HIV‐positive patients receiving long‐term ART at two tertiary hospitals in Addis Ababa, Ethiopia, highlighting the need for routine lipid monitoring and integrated cardiovascular risk management within HIV care settings in similar urban, tertiary‐care contexts.
Nebiat Adane, Mekoya Mengistu, Tariku Fekadu et al.· AIDS Research and Treatment· 0 citations
Tuberculosis incidence was relatively low, while isoniazid use was protective, and poor adherence, opportunistic infections, and large family size increased risk, while isoniazid use was protective.
Wabiw Addis, Adugnaw Zeleke, S. Nigatu et al.· Journal of the International...· 0 citations
High CD4 count was the risk factor for generalized obesity and female sex, being married and high CD4 count were risk factors for abdominal obesity among PLHIV.
Ramesh Masthi NR, Pruthvi S, Lavanya R et al.· National Journal of Communit...· 0 citations
Results underscore the crucial importance of high-quality obstetric and neonatal care, as well as antenatal monitoring, for improving newborn survival and call for strengthened antenatal care, improved screening and management of at-risk newborns in healthcare facilities, and the integration of these indicators into strategies for reducing neonatal mortality in resource-limited settings.
F. Kabasubabo, H. Bezanahary, Julien Magne et al.· PLOS Global Public Health· 0 citations
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