DOI: 10.21045/2071-5021-2018-61-3-10

Vladimirov A.V.¹, Tsybikova E.B.^2
1 Khanty-Mansi clinical TB dispensary, Khanty-Mansiysk
² Federal Research Institute for Health Organization and Informatics of Ministry of Health of the Russian Federation, Moscow

Contacts: Erzheni Tsybikova, e-mail: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it
Information about authors:
Tsybikova E.B.  https://orcid.org/0000-0002-9131-3584
Vladimirov A.V.  https://orcid.org/0000-0003-1534-3295
Acknowledgments. The study had no sponsorship.
Conflict of interests. The authors declare no conflict of interest.

Abstract.

Significance. During the last 15 years the share of deaths from TB has reduced from 78% to 39% while the share of deaths from HIV-infection increased from 6.8% to 45% in the Russian structure of infectious deaths.  Increasing HIV mortality in Russia is largely conditioned by high prevalence of TB-HIV co-infection. Therefore,  analysis of the death cause structure of HIV-infected patients with due regard to age including external causes of death, as well as changes that occurred during the past years seems well-timed and relevant.

Purpose: to study dynamics in the structure of death causes in HIV-infected patients by age groups in the Khanty-Mansi Autonomous Area (Yugra) in 2003-2016.

Materials and methods: data from death certificates (form #106/u-08) and Rosstat reporting form #61 of the Khanty-Mansi Autonomous Area (Yugra) for 2003-2004, 2008-2009, 2013-2014 and 2015-2016, as well as Rosstat data on population number by sex and age. Statistical and comparative analyses were applied using Statistica and BioStat packages.

Results. Over the last years the Khanty-Mansi Autonomous Area (Yugra) has seen an increased number of deaths among both newly diagnosed  cases and HIV infected cohorts with a shift to older age groups (35 and over). Such situation is indicative of a substantial HIV prevalence in population reaching beyond the major risk groups.

The increased share of HIV cohorts with the most severe 4^th stage of HIV infection up to 29.8% suggests a late HIV diagnosis and low access to ART.

Analysis of the death cause structure in HIV patients showed that in 2016 the number of patients died from HIV 4.6 times exceeded the number of deaths from external causes.

HIV patients over 35 years constitute the main “risk group” of premature mortality due to both HIV-infection and external causes.

Analysis of the structure of external causes of death showed that intentional self harm (ICD-10 X60-X84) and event of undetermined intent (ICD-10 Y10-Y34) accounted for the highest shares totaling up to 90.4%±11.4%.

The causes of high lethality from HIV-infection included late diagnosis, low access to ART as well as low effectiveness of TB-HIV treatment.

Keywords: HIV infection; death causes in HIV patients; external death causes in HIV patients; lethality; age structure.

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