AIDS-related and non-AIDS causes of in-hospital death among people living with HIV: a multicenter retrospective study

Despite advances in antiretroviral therapy (ART), mortality remains an important concern among people living with HIV (PLWH). This study described the causes of in-hospital death and compared AIDS-related and non-AIDS-related deaths among 138 adults PLWH who died during hospitalization at 12 tertiary-care HIV centers in Türkiye between 2014 and 2025. Demographic, clinical, and HIV-related data were collected from medical records. Causes of death were classified as AIDS-related or non-AIDS-related using ICD-10-coded diagnoses and CDC/WHO AIDS-defining conditions. Overall, 138 in-hospital deaths were analyzed. AIDS-related deaths accounted for 56.5%. The leading AIDS-related causes were Pneumocystis jirovecii pneumonia, toxoplasmic encephalitis, and tuberculosis, whereas sepsis and respiratory conditions predominated among non-AIDS-related deaths. AIDS-related deaths were characterized by lower CD4 cell counts and more frequent AIDS-defining illness at diagnosis. Smoking (OR = 7.23, 95% CI 1.07–48.75, p = 0.042) and AIDS-defining illness at diagnosis (OR = 6.18, 95% CI 1.18–32.32, p = 0.031) were independently associated with AIDS-related rather than non-AIDS-related in-hospital death. AIDS-related causes remain prominent among in-hospital deaths despite the ART era. Earlier HIV diagnosis, timely ART initiation, and optimized prevention and management of opportunistic infections and comorbidities are essential to improve outcomes.

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Journal
AIDS Care
Published
2026-09-15
DOI
https://doi.org/10.1080/09540121.2026.2729941
Primary Topic
Pneumocystis jirovecii pneumonia detection and treatment
Type
article
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article

AIDS-related and non-AIDS causes of in-hospital death among people living with HIV: a multicenter retrospective study

Damla Ertürk, Mustafa Kemal Çelen, Sibel Kuyugöz, Mehmet Çabalak et al.
AIDS Care
Pneumocystis jirovecii pneumonia detection and treatment
article

AIDS-related and non-AIDS causes of in-hospital death among people living with HIV: a multicenter retrospective study

Damla Ertürk, Mustafa Kemal Çelen, Sibel Kuyugöz, Mehmet Çabalak, Handan Alay, Ayhan Akbulut, Berfin Çirkin Doruk, Gülden Ersöz, Selma Güler, Şafak Kaya, Mehmet Ali Aşan, Çiğdem Mermutluoğlu, Dilara İnan, Yeşim Taşova, Tuğçe Şimşek Bozok, Tuba Damar Çakırca, İlkay Karaoğlan, Irem Ece Darbaz
article en

Abstract

Despite advances in antiretroviral therapy (ART), mortality remains an important concern among people living with HIV (PLWH). This study described the causes of in-hospital death and compared AIDS-related and non-AIDS-related deaths among 138 adults PLWH who died during hospitalization at 12 tertiary-care HIV centers in Türkiye between 2014 and 2025. Demographic, clinical, and HIV-related data were collected from medical records. Causes of death were classified as AIDS-related or non-AIDS-related using ICD-10-coded diagnoses and CDC/WHO AIDS-defining conditions. Overall, 138 in-hospital deaths were analyzed. AIDS-related deaths accounted for 56.5%. The leading AIDS-related causes were Pneumocystis jirovecii pneumonia, toxoplasmic encephalitis, and tuberculosis, whereas sepsis and respiratory conditions predominated among non-AIDS-related deaths. AIDS-related deaths were characterized by lower CD4 cell counts and more frequent AIDS-defining illness at diagnosis. Smoking (OR = 7.23, 95% CI 1.07–48.75, p = 0.042) and AIDS-defining illness at diagnosis (OR = 6.18, 95% CI 1.18–32.32, p = 0.031) were independently associated with AIDS-related rather than non-AIDS-related in-hospital death. AIDS-related causes remain prominent among in-hospital deaths despite the ART era. Earlier HIV diagnosis, timely ART initiation, and optimized prevention and management of opportunistic infections and comorbidities are essential to improve outcomes.

AIDS Care
Dicle University (TR), Akdeniz University (TR), Infectious Disease Consultants (US), Akdeniz University Hospital (TR), Education Training And Research (US), Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi (TR), Mustafa Kemal University (TR), Kahramanmaraş Sütçü İmam University (TR), Mersin Üniversitesi (TR), Cukurova University (TR), Gaziantep University (TR), Atatürk University (TR), Harran University (TR)
Good health and well-being
Openalex Percentile: Top 10%
Pneumocystis jirovecii pneumonia detection and treatment
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