Causes of Death in Hospitalised Human Immunodefi ciency Virus (HIV)-infected Patients at a National Referral Centre in Singapore: A Retrospective Review

Introduction: Highly active antiretroviral therapy (HAART) has improved outcomes for individuals infected with human immunodefi ciency virus (HIV). This study describes the causes of death in hospitalised HIV-positive patients from 2008 to 2010 in Tan Tock Seng Hospital, the national referral centre for HIV management in Singapore. Materials and Methods: Data were retrospectively collected from HIV-positive patients who died in Tan Tock Seng Hospital from January 2008 to December 2010. Results: Sixty-seven deaths occurred in the study period. A majority of patients died of non-acquired immune defi ciency syndrome (AIDS)-defi ning illnesses (54.7%). The median CD4 count was 39.5 (range, 20.0 to 97.0), and 7 patients had HIV viral loads of <200 copies/mL. There were 27 deaths due to opportunistic infections, 27 due to non AIDS-defi ning infections, 4 due to non AIDS-associated malignancies. This study also describes 3 deaths due to cardiovascular events, and 1 due to hepatic failure. Patients who had virologic suppression were more likely to die from non AIDS-defi ning causes. Conclusion: Causes of death in HIV-positive patients have changed in the HAART era. More research is required to further understand and address barriers to testing and treatment to further improve outcomes in HIV/AIDS. Ann Acad Med Singapore 2012;41:571-6