Causes of death and mortality trends among Utah HIV/AIDS cases, 2000-2011

With the advent of highly active antiretroviral therapy, people living with HIV/AIDS (PLWHA) are living longer and the incidence and causes of death have changed.   Understanding these changes will help treatment programs to support the evolving needs of PLWHA. The objective of this analysis was to determine the causes of death and mortality trends among HIV/AIDS cases in Utah between 2000 and 2011.

Electronic record linkage was utilized to match cases reported in the Utah Enhanced HIV/AIDS Reporting System with vital statistics death certificate records from 2000 to 2011 and data were subset to include matches validated by first and last name, gender, and social security number.  Underlying causes of death were categorized by ICD-10 code and tabulated for frequency.  Mortality trends and age of mortality by year were compared using the Cochran-Armitage and ANOVA tests for trend, respectively. 

Among the 191 cases identified, the mean age of death per year increased significantly over the time period between 2000 and 2011 (p=0.040).  Deaths from AIDS-defining illnesses declined significantly over time (p=0.046), although they remained the predominant cause of mortality (58% of deaths overall).  Frequently identified underlying causes of death included poisonings which were accidental, intentional, or of undetermined intent and cardio-cerebrovascular events (8% and 6% of deaths overall, respectively). There were significant increases in the deaths which were attributed to suicide (p=0.002) and malignant neoplasms (p=0.038) over this time period. 

HIV/AIDS cases in Utah are living longer with lower rates of mortality due to AIDS-defining illnesses.  Cardio-cerebrovascular conditions and malignant neoplasms are important clinical considerations among HIV-positive individuals. Additionally, ensuring sustained access to mental health services will be important in the effort to decrease mortality among HIV/AIDS cases in Utah.