(updated with full article)
HIV+ people in hospital who were on anti-retrovirals were more likely to die of non-AIDS conditions than HIV+ people NOT being treated with ARVs. The deaths were owing to known “side” effects of ARVs: cardiovascular, liver, various infections.
That is reported in the paper drawn to my attention by a comment from lukas. Note that the data covers a period of 16 years beginning with the introduction of “life-saving HAART cocktails” in the mid-1990s:
Cowell et al., TRENDS IN HOSPITAL DEATHS AMONG HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENTS DURING THE ANTIRETROVIRAL THERAPY ERA, 1995 TO 2011,
Journal of Hospital Medicine, 30 June 2015 doi: 10.1002/jhm.2409. [Epub ahead of print]
Here is the full paper, courtesy of David Rasnick:
And here is just the abstract:
In-hospital deaths declined significantly from 1995 to 2011 (P < 0.0001); those attributable to non-AIDS increased (43% to 70.5%, P < 0.0001). Non-AIDS deaths were most commonly caused by non-AIDS infection (20.3%), cardiovascular (11.3%) and liver disease (8.5%), and non-AIDS malignancy (7.8%). Patients with non-AIDS compared to AIDS-related deaths were older (median age 48 vs 40 years, P < 0.0001), more likely to be on ART (74.1% vs 55.8%, P = 0.0001), less likely to have a CD4 count of <200 cells/mm3 (47.2% vs 97.1%, P < 0.0001), and more likely to have an HIV viral load of ≤400 copies/mL (38.1% vs 4.1%, P < 0.0001). Non-AIDS deaths were associated with 4.5 and 4.2 times greater likelihood of comorbid underlying liver and cardiovascular disease, respectively.
Non-AIDS deaths increased significantly during the ART era and are now the most common cause of in-hospital deaths; non-AIDS infection, cardiovascular and liver disease, and malignancies were major contributors to mortality. Higher CD4 cell count, liver, and cardiovascular comorbidities were most strongly associated with non-AIDS deaths. Interventions targeting non-AIDS-associated conditions are needed to reduce inpatient mortality among HIV-infected patients. Journal of Hospital Medicine 2015. © 2015 Society of Hospital Medicine.
© 2015 Society of Hospital Medicine.
This journal is not held by our library, and I’m waiting for Interlibrary Loan to get me a copy. IN the meantime, the abstract’s details given above seem to tell the story clearly enough.