Predictors of All-cause Mortality among Hospitalized HIV Patients in Kazakhstan: a Retrospective Study

Karina Saduyeva 1 * , Gulnur Zhakhina 1, Aiida Karsybay 1, Assyl Kuzentay 1, Iliyar Arupzhanov 1, Ablay Bulegenov 1, Temirgali Aimyshev 1, Abduzhappar Gaipov 1
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1 Department of Medicine, School of Medicine at the Nazarbayev University, Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 5, pp. 27-34. https://doi.org/10.23950/jcmk/15488
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Author Contributions: Conceptualization, K. S. and A. G.; methodology, K. S., G. Z., I. A., A. B. and T. A.; validation, K. S.; formal analysis, K. S., A. K. and A. K.; investigation, K. S., A. K. and A. K.; resources, K. S.; data curation, K. S., G. Z., A. K., A. K., I. A., A. B. and T. A; writing – original draft preparation, K.S.; writing – review and editing, K. S., G. Z. and A. G.; visualization, K. S., I. A., A. B. and T. A.; supervision, A. G.; project administration, K. S. and A. G.; funding acquisition – not applicable. All authors have read and agreed to the published version of the manuscript.

ABSTRACT

Aim: This paper examines the predictors of all-cause mortality among hospitalized HIV-positive patients in Kazakhstan.
Material and methods: The study uses baseline data from patient hospital discharge records derived from the Unified Electronic Healthcare System of Kazakhstan (UNEHS) between 2014 and 2019. Artificial intelligence technology was utilized to extract data from the discharge records. Patients were included based on their first hospitalization, and they were subsequently monitored until their discharge or occurrence of death.
Results: The study revealed that females had a 2.06-fold higher risk of all-cause mortality compared to males. After adjustments in the Cox proportional hazard model, age, intravenous drug use (IDU), and anemia were observed as independent predictors of mortality within the patient cohort.
Conclusions:  Findings of this study emphasize the need to enhance efforts to prevent late HIV diagnosis by improving access to testing and treatment for those affected, and to strengthen potential for developing risk factors reduction strategies.

CITATION

Saduyeva K, Zhakhina G, Karsybay A, Kuzentay A, Arupzhanov I, Bulegenov A, et al. Predictors of All-cause Mortality among Hospitalized HIV Patients in Kazakhstan: a Retrospective Study. J CLIN MED KAZ. 2024;21(5):27-34. https://doi.org/10.23950/jcmk/15488

REFERENCES

  • Keele BF, Heuverswyn FV, Li Y, Bailes E, Takehisa J, Santiago ML, et al. Chimpanzee Reservoirs of Pandemic and Nonpandemic HIV-1. Science. 2006; 313(5786), 523–526. https://doi.org/10.1126/science.1126531
  • Ekholuenetale M, Onuoha H, Ekholuenetale CE, Barrow A, & Nzoputam CI. Socioeconomic Inequalities in Human Immunodeficiency Virus (HIV) Sero-Prevalence among Women in Namibia: Further Analysis of Population-Based Data. International Journal of Environmental Research and Public Health. 2021; 18(17), 9397. https://doi.org/10.3390/ijerph18179397
  • Aringazina A, Gulis G, Allegrante JP. Public Health Challenges and Priorities for Kazakhstan. Central Asian Journal of Global Health. 2012; 1(1). https://doi.org/10.5195/cajgh.2012.30
  • UNAIDS. Kazakstan Overview. 2019. https://www.unaids.org/en/regionscountries/countries/kazakhstan.
  • Mussina K, Abbay A, Sakko Y, Syssoyev D, Gusmanov A, Abdrakhmanova A, Ashimkhanova A, Gaipov A. Dynamics of hospital admissions and all-cause mortality of HIV infected patients in Kazakhstan: data from unified nationwide electronic healthcare system 2014–2019. Front. Public Health. 2023; 11:1138604. https://doi.org/10.3389/fpubh.2023.1138604
  • Babiker AG, Peto T, Porter K, Walker AS, Darbyshire JH. Age as a determinant of survival in HIV infection. Journal of Clinical Epidemiology. 2001; 54(12), S16–S21. https://doi.org/10.1016/s0895-4356(01)00456-5
  • Miller CJ, Baker JV, Bormann AM, Erlandson KM, Huppler HK, Justice AC, et al. Adjudicated Morbidity and Mortality Outcomes by Age among Individuals with HIV Infection on Suppressive Antiretroviral Therapy. PLoS ONE. 2014; 9(4), e95061. https://doi.org/10.1371/journal.pone.0095061
  • Gao D, Zou Z, Dong B, Zhang W, Chen T, Cui W, et al. Secular trends in HIV/AIDS mortality in China from 1990 to 2016: Gender disparities. PLoS ONE. 2019; 14(7), e0219689. https://doi.org/10.1371/journal.pone.0219689
  • Moore RD. Epidemiology of HIV infection in the United States: Implications for linkage to care. Clinical Infectious Diseases, 2011; 52(suppl_2), S208–S213. https://doi.org/10.1093/cid/ciq044
  • Ertunç B, Kaya S, Köksal İ. Clinico-Epidemiological analysis of HIV/AIDS patients. The Eurasian Journal of Medicine. 2016; 48(3), 157–161. https://doi.org/10.5152/eurasianjmed.2016.15203
  • Chen Y, Wang W, Zeng L, Mi K, Li N, Shi J, Yang, S. Association Between Neutrophil-Lymphocyte Ratio and All-Cause Mortality and Cause-Specific Mortality in US Adults, 1999–2014. International Journal of General Medicine. 2021; 14:10203–10211. https://doi.org/10.2147/ijgm.s339378
  • Raffetti E, Donato F, Casari S, Castelnuovo F, Sighinolfi L, Bandera A, et al. Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study. BMC Infectious Diseases. 2017; 17(1), 193. https://doi.org/10.1186/s12879-017-2280-5
  • Edelman EJ, Tetrault JM, Fiellin DA.Substance use in older HIV-infected patients. Current Opinion in HIV and AIDS. 2014; 9(4), 317–324. https://doi.org/10.1097/coh.0000000000000069
  • Kariuki W, Manuel JI, Kariuki N, Tuchman E, O’Neal J, Lalanne GA. HIV and smoking: associated risks and prevention strategies. HIV/AIDS – Research and Palliative Care. 2015; 2016:8, 17-36. https://doi.org/10.2147/hiv.s56952
  • Glushkova N, Smailova DS, Namazbayeva Z, Mukasheva G, Zhamakurova A, Kuanyshkalieva A, et al. Prevalence of smoking various tobacco types in the Kazakhstani adult population in 2021: A Cross-Sectional study. International Journal of Environmental Research and Public Health. 2023; 20(2), 1509. https://doi.org/10.3390/ijerph20021509
  • Wing EJ. HIV and aging. International Journal of Infectious Diseases. 2016; 53, 61–68. https://doi.org/10.1016/j.ijid.2016.10.004
  • Raffetti E, Donato F, Casari S, Crea F, Sighinolfi L, Bandera A, et al. Systemic inflammation-based scores and mortality for all causes in HIV-infected patients: a MASTER cohort study. BMC Infectious Diseases (Online). 2017; 17(1), 193. https://doi.org/10.1186/s12879-017-2280-5
  • Mocroft A, Lundgren JD, Sabin ML, Monforte AA, Brockmeyer NH, Casabona J, et al. Risk Factors and Outcomes for Late Presentation for HIV-Positive Persons in Europe: Results from the Collaboration of Observational HIV Epidemiological Research Europe Study (COHERE). PLOS Medicine. 2013; 10(9), e1001510–e1001510. https://doi.org/10.1371/journal.pmed.1001510
  • Van De Laar, MJ, Likatavicius G, Stengaard AR, Donoghoe MC. HIV/AIDS surveillance in Europe: update 2007. Eurosurveillance. 2007; 13(50), 19066. https://doi.org/10.2807/ese.13.50.19066-en
  • El‐Bassel N, Gilbert L, Terlikbayeva A, Wu E, Beyrer C, Shaw SA, et al. HIV among injection drug users and their intimate partners in Almaty, Kazakhstan. AIDS and Behavior. 2013; 17(7), 2490–2500. https://doi.org/10.1007/s10461-013-0484-2
  • Widiyanti M, Ubra R, Fitriana, E. Low body mass index increases risk of anemia in patients with HIV-AIDS receiving antiretroviral therapy. Universa Medicina. 2017; 36(3), 221–227. https://doi.org/10.18051/univmed.2017.v36.221-227
  • Mocroft A, Kirk O, Barton SE, Dietrich M, Proenca R, Colebunders R, et al. Anaemia is an independent predictive marker for clinical prognosis in HIV-infected patients from across Europe. EuroSIDA study group. AIDS (London, England). 1999; 13(8), 943–950. https://doi.org/10.1097/00002030-199905280-00010
  • Ndakotsu MA, Salawu L, Durosinmi M. Relation between erythrocyte sedimentation rate, clinical and immune status in HIV Infected patients. Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria. 2009; 18(2). https://doi.org/10.4314/njm.v18i2.45067
  • Alfano G, Cappelli G, Fontana F, Di Lullo L, Di Iorio B, Bellasi A, Guaraldi G. Kidney Disease in HIV Infection. Journal of Clinical Medicine, 2019; 8(8), 1254. https://doi.org/10.3390/jcm8081254