Trend and cause of death of HIV-infected patients in Japan:A descriptive study using hospital admission records

抄録

The life-expectancy of people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA) has substantially increased over the past decade owing to improved antiretroviral therapies. The cause and trend of mortality in PLWHA is expected to differ from the previous prognostic models. In this descriptive study, we extracted the records of HIV-infected patients from the admissions database of an academic medical center in Japan, and evaluated the trend and cause of death in this cohort. A total of 115 admission records from 75 hospitalized HIV-infected individuals were available from the years 2014-2018. The mean age at last hospital admission was significantly higher in the mortality group than the non-mortality group (67.9 ± 16.6 years v.s. 44.8 ± 12.4 years, p = 0.008). The mean age at first HIV diagnosis and the mean length of hospital stay were also significantly greater in the mortality group than the non-mortality group (age at first HIV diagnosis:58.3 ± 18.3 v.s. 39.3 ± 10.7 years, p = 0.032;length of hospital stay:40.0 ± 26.0 v.s. 13.9 ± 16.2 days, p = 0.014). The causes of death in the 4 patients were not directly AIDS-defining (i.e. idiopathic cytopenia purpura, brain tumor, tongue cancer, and anal cancer). In conclusion, the present preliminary analysis indicates that the life expectancy of PLWHA may also have extended in Japan, and the implementation of appropriately designed healthcare policies is required to accommodate the aging PLWHA population. Larger confirmatory studies are needed to control for inherent confoundings.