AIDS-defining illnesses were the second most common cause of death in adult HIV patients in London in 2016, according to new data from the London HIV Mortality Review Group. AIDS accounted for 37 (22%) of the 169 deaths for which a cause was ascertained. These illnesses are potentially preventable with earlier HIV diagnosis and/or improved support for patients not engaged with HIV care, the authors noted.
- The leading cause of death was non-AIDS-related cancers, which accounted for 40 deaths. Other common causes were cardiovascular disease and stroke (23 deaths), non-AIDS-related infections (14 deaths) and liver disease (12 deaths).
- There was a high prevalence of comorbidities: 39% of patients had a history of depression, 33% had chronic hypertension, 27% had dyslipidaemia, 17% had coinfection with hepatitis B virus and/or hepatitis C virus, and 14% had diabetes mellitus.
- Health risks were also highly prevalent: tobacco smoking was reported in 37%, excessive alcohol consumption in 19%, non‐injecting drug use in 10%, injecting drug use in 7% and opioid substitution therapy in 6%.
- At the time of death, 81% of patients were on antiretroviral therapy, 61% had a CD4 count < 350 cells/μL, and 24% had a viral load ≥ 200 HIV‐1 RNA copies/mL
Of the 206 deaths reported, 77% were among men and median age of death was 56 years. Cause was available for 82% of deaths. All London HIV care trusts reported data. The authors noted that HIV patients in London are not representative of people with HIV in the UK as a whole, and called for a national mortality review.
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