CAUSES DE DECES DES PATIENTS VIH POSITIF SOUS TRAITEMENT ANTIRETROVIRAL, HOSPITALISES A L’HOPITAL DE SIKASSO

Abstract: Despite access to ARVs, HIV-infected patients are not immune to opportunistic infections. The aim of this study was to identify the causes of the deaths of people with HIV on ARVs, hospitalized in the Sikasso hospital, in order to improve the preventive and curative management of these opportunistic infections. From 1 July 2014 to 31 December 2015, we conducted a retrospective and descriptive study of 35 patients on antiretroviral treatment who died at the Sikasso hospital. Type 1 HIV infection was predominant with 94.2% of cases. Low socioeconomic status, poor adherence to ARVs and severe immunosuppression were the contributing factors in the development of opportunistic infections. Chronic cough and altered general status were the most incriminating reasons for hospitalization, with 20% of cases each. All patients received primary chemoprophylaxis with cotrimoxazole. Tuberculosis was the most opportunistic infection associated with deaths with 57.1% of cases in its multifocal form and 2.9% of cases in its pulmonary form, followed by mycotic esophagitis, cerebral toxoplasmosis and gastroenteritis (Cryptosporidiosis and isosporosis) with respectively: 17.1%; 11.2% and 8.6% of cases. The CD4 cell counts of the patients were much collapsed with a death rate of 100% at less than 50 cells / mm3. The combination of zidovudine + lamivudine + efavirenz was the most widely used ARV regimen in 37.1% of cases. Tuberculosis remains the first infection, causing deaths of patients living with HIV on ARVs, and good adherence to therapeutics will help reduce the death rate. Key words: cause-death-patients-antiretroviral-Sikasso