Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort
Objective. To identify clinical characteristics and risk factors associated with mortality, with a focus on opportunistic infections (OIs), in patients with advanced HIV in Brazil. Methods. A prospective cohort study was conducted in five Brazilian tertiary hospitals, including 419 adults with advan...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Pan American Health Organization
2025-04-01
|
| Series: | Revista Panamericana de Salud Pública |
| Subjects: | |
| Online Access: | https://iris.paho.org/handle/10665.2/66224 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850149826277146624 |
|---|---|
| author | Nicole Reis Omar Sued Tarsila Vieceli Diego R. Falci Larissa R. Silva Pedro M. Fonseca Renata B. A. Soares Cassia S. M. Godoy Marineide G. Melo Nayla A. Hatem Ana C. G. Castelo Freddy Perez Alessandro C. Pasqualotto |
| author_facet | Nicole Reis Omar Sued Tarsila Vieceli Diego R. Falci Larissa R. Silva Pedro M. Fonseca Renata B. A. Soares Cassia S. M. Godoy Marineide G. Melo Nayla A. Hatem Ana C. G. Castelo Freddy Perez Alessandro C. Pasqualotto |
| author_sort | Nicole Reis |
| collection | DOAJ |
| description | Objective. To identify clinical characteristics and risk factors associated with mortality, with a focus on opportunistic infections (OIs), in patients with advanced HIV in Brazil.
Methods. A prospective cohort study was conducted in five Brazilian tertiary hospitals, including 419 adults with advanced HIV. Baseline demographic and clinical data were collected during hospital admission, and participants were screened for tuberculosis, cryptococcosis, and histoplasmosis using rapid diagnostic tests. Participants were followed for 90 days to assess mortality, with causes of death classified using the Coding of Death in HIV (CoDe) protocol. Statistical analysis identified the variables associated with mortality.
Results. The median CD4 count was 66 cells/mm³, and the median HIV viral load was 104 887 copies/mL. After 90 days, 18.1% of participants had died. ART-naive status, mental confusion, anemia, and elevated creatinine levels were strongly associated with mortality. OIs were diagnosed in 45.6% of participants, with severe histoplasmosis and cryptococcal meningitis significantly increasing the risk of mortality. Social determinants, such as sex, race, gender, and education level, did not have a significant impact on mortality, but socio-economic factors influenced health care access.
Conclusion. Early HIV diagnosis and continuous ART are essential to reduce mortality. Public health strategies should prioritize improving HIV testing, treatment adherence, and addressing social disparities to mitigate health care inequalities. |
| format | Article |
| id | doaj-art-08f84b2b71a441808b0143e8b526207d |
| institution | OA Journals |
| issn | 1020-4989 1680-5348 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Pan American Health Organization |
| record_format | Article |
| series | Revista Panamericana de Salud Pública |
| spelling | doaj-art-08f84b2b71a441808b0143e8b526207d2025-08-20T02:26:46ZengPan American Health OrganizationRevista Panamericana de Salud Pública1020-49891680-53482025-04-0149361910.26633/RPSP.2025.36rpspPredictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohortNicole Reis0Omar Sued1Tarsila Vieceli2Diego R. Falci3Larissa R. Silva4Pedro M. Fonseca5Renata B. A. Soares6Cassia S. M. Godoy7Marineide G. Melo8Nayla A. Hatem9Ana C. G. Castelo10Freddy Perez11Alessandro C. Pasqualotto12Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.Pan American Health Organization, Washington, DC, United States of America.Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.Grupo Hospitalar Conceição, Porto Alegre, Brazil.Hospital Estadual de Doenças Tropicais Dr Anuar Auad, Goiânia, Brazil.Hospital Estadual de Doenças Tropicais Dr Anuar Auad, Goiânia, Brazil.Grupo Hospitalar Conceição, Porto Alegre, Brazil.Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.Pan American Health Organization, Washington, DC, United States of America.Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.Objective. To identify clinical characteristics and risk factors associated with mortality, with a focus on opportunistic infections (OIs), in patients with advanced HIV in Brazil. Methods. A prospective cohort study was conducted in five Brazilian tertiary hospitals, including 419 adults with advanced HIV. Baseline demographic and clinical data were collected during hospital admission, and participants were screened for tuberculosis, cryptococcosis, and histoplasmosis using rapid diagnostic tests. Participants were followed for 90 days to assess mortality, with causes of death classified using the Coding of Death in HIV (CoDe) protocol. Statistical analysis identified the variables associated with mortality. Results. The median CD4 count was 66 cells/mm³, and the median HIV viral load was 104 887 copies/mL. After 90 days, 18.1% of participants had died. ART-naive status, mental confusion, anemia, and elevated creatinine levels were strongly associated with mortality. OIs were diagnosed in 45.6% of participants, with severe histoplasmosis and cryptococcal meningitis significantly increasing the risk of mortality. Social determinants, such as sex, race, gender, and education level, did not have a significant impact on mortality, but socio-economic factors influenced health care access. Conclusion. Early HIV diagnosis and continuous ART are essential to reduce mortality. Public health strategies should prioritize improving HIV testing, treatment adherence, and addressing social disparities to mitigate health care inequalities.https://iris.paho.org/handle/10665.2/66224hivaids-related opportunistic infectionspoint-of-care testingmortalityrisk factors |
| spellingShingle | Nicole Reis Omar Sued Tarsila Vieceli Diego R. Falci Larissa R. Silva Pedro M. Fonseca Renata B. A. Soares Cassia S. M. Godoy Marineide G. Melo Nayla A. Hatem Ana C. G. Castelo Freddy Perez Alessandro C. Pasqualotto Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort Revista Panamericana de Salud Pública hiv aids-related opportunistic infections point-of-care testing mortality risk factors |
| title | Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort |
| title_full | Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort |
| title_fullStr | Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort |
| title_full_unstemmed | Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort |
| title_short | Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort |
| title_sort | predictors of mortality among individuals with advanced hiv disease in a contemporary brazilian cohort |
| topic | hiv aids-related opportunistic infections point-of-care testing mortality risk factors |
| url | https://iris.paho.org/handle/10665.2/66224 |
| work_keys_str_mv | AT nicolereis predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT omarsued predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT tarsilavieceli predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT diegorfalci predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT larissarsilva predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT pedromfonseca predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT renatabasoares predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT cassiasmgodoy predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT marineidegmelo predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT naylaahatem predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT anacgcastelo predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT freddyperez predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort AT alessandrocpasqualotto predictorsofmortalityamongindividualswithadvancedhivdiseaseinacontemporarybraziliancohort |