Dynamics and structure of HIV infection cases in forensic practice

A significant proportion of HIV-infected deceased persons are autopsied in forensic medical examination institutions. However, a detailed analysis of such observations is not carried out. Aim of the study. The study was conducted to identify medical and social characteristics and causes of death of patients with HIV infection based on the results of independent epidemiological monitoring based on the work of the forensic medical bureau of St. Petersburg. Material and methods. The analysis and detailing of the structure of mortality from HIV infection in dynamics over the past five years from 2018 to 2022 was performed. Quantitative indicators were obtained reflecting the forensic diagnosis of HIV infection as the main (initial) and concomitant diseases, with distribution by gender and age, the frequency of occurrence of HIV-associated diseases. Results and discussion. Of the 268 deceased HIV-infected patients over the analyzed five-year period, the proportion of women was 22.4%, men — 77.6%, there is a tendency towards an annual increase in the number of deaths in older age groups. The main causes of death were: «external causes» (poisoning with psychoactive substances, various types of injuries, suicides)— in 101 (37.8%), HIV infection in the AIDS stage (TB, HIV-associated cancer) — in 73 (26.9%) new coronavirus infection (in 2020–2022) — in 13 (10.7%) people. Concomitant diseases against the background of HIV infection were identified in 262 (98%) patients, the most common being chronic viral hepatitis (37%), fatty liver disease (23.4%), cardiovascular diseases (23.2%), pneumonia (16.4%), and oncopathology (4.2%). Conclusion. Thus, the analysis of the obtained data demonstrated an annual decrease in the number of patients with HIV infection admitted to the BSME for determining the cause of death. Nevertheless, a detailed analysis of the autopsy materials conducted in the forensic medical service system over the past 5 years made it possible to identify the key signs and significance of HIV infection when considering the causes of death, and to obtain information on the structure of concomitant and opportunistic diseases in patients.