Causes of death among patients with HIV in Singapore from 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS)

Abstract

ObjectivesTo investigate the major primary and contributory causes of death among HIV patients in Singapore. DesignA retrospective observational cohort study of all adult patients seen at the national referral centre for HIV in Singapore between 1985 and 2001. MethodsData were extracted from the patients' records by 10 trained health care workers. AIDS-defining conditions were established using predefined criteria. For each case, a single principal cause of death and up to three contributory causes were identified. ResultsA total of 1504 patients aged 17 years or over were seen before the end of 2001, of whom 504 have died. The most frequent principal causes of death were Mycobacterium avium (17.5%), Mycobacterium tuberculosis (9.7%), pneumonia (cause unknown) (6.5%) and Cryptococcus neoformans (6.7%). Three hundred and eighteen patients (63.1%) died from an AIDS-defining condition. ConclusionsThe causes of death were similar to those found in Western cohorts, except that disseminated M. avium was a more frequent cause of death.

Changing HIV Infection–Related Mortality Rate and Causes of Death Among Persons With HIV Infection Before and After the Introduction of Highly Active Antiretroviral Therapy

“…15 Overall, AIDS-related conditions were at least 1 of the causes of death in more than four fifths of the HIV-infected persons who died during 1997 through 2005, both before and after the introduction of HAART in 2002. This finding is unlike the finding of an increasing proportion of AIDS-unrelated causes of death among these persons reported from developed countries in recent years [16][17][18] However, in these settings, HAART has been in use for more than 10 years. Reports from developing countries where HAART has been a more recent phenomenon, AIDS-related illnesses were the cause of death in the majority of the cases.…”

AIDS-defining illnesses among patients with HIV in Singapore, 1985 to 2001: results from the Singapore HIV Observational Cohort Study (SHOCS)

“…The details of the SHOCS cohort have been described previously [34]. The study was approved by the Ethics Committee of Tan Tock Seng Hospital.…”

“…Data were extracted from the case notes of all Singaporean residents who were seen at CDC on or before 31 st December 2001, by ten trained healthcare workers. Probable and confirmed criteria were developed for the diagnosis of category C [34] and category B (AIDS-related complex) conditions, based on the 1993 guidelines of the United States' Centers for Disease Control and Prevention [35]. …”

Environmental Mycobacteria: A Threat to Human Health?

“…Recently, an increase (not due to better sampling or detection procedures) has been found in infections with M. avium in the aging population from The Netherlands with chronic obstructive pulmonary disease (van Ingen et al, 2010a). M. avium strains have been isolated from patients with AIDS (Bellamy et al, 2004) and seem to be a major cause of death. The high incidence of M. avium infections is correlated with high numbers of these bacteria in environmental or drinking water (Glover et al, 1994;Pierce, 2009), but dust from potting soil (especially peat) may also be a source of human infections (De Groote et (Wu et al, 2006).…”