Predictors of mortality among individuals with advanced HIV disease in a contemporary Brazilian cohort

Bibliographic Data

ID14965711
AuthorsNicole Reis (0000-0002-5797-2156, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil., corresponding author), Omar Sued (0000-0001-5818-770X, Pan American Health Organization, Washington, DC, United States of America.), Tarsila Vieceli (0000-0001-6274-1320, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.), Diego Rodrigues Falci (0000-0002-8683-3833, Hospital de Clínicas de Porto Alegre), Larissa R Silva (0000-0002-7686-2382, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.), Pedro Moreno Fonseca (0000-0003-3050-4202, Grupo Hospitalar Conceição), Renata de Bastos Ascenço Soares (0000-0003-1029-325X, Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais), Cassia S M Godoy (Hospital Estadual de Doenças Tropicais Dr Anuar Auad, Goiânia, Brazil.), Marineide Gonçalves de Melo (0009-0000-0567-8943, Grupo Hospitalar Conceição), Nayla A Hatem (0000-0001-6062-4286, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.), Ana Carolina Gonçalves Castelo (Universidade Federal de Ciências da Saúde de Porto Alegre), Federico Pérez (0000-0003-2001-0057, World Health Organization Regional Office for the Americas), Freddy Pérez (Pan American Health Organization, Washington, DC, United States of America.), Alessandro C Pasqualotto (0000-0002-6782-5395, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.)
Year2026
Volume49
Pages1
Publication date2026-03-19
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueRevista Panamericana de Salud Pública (JOURNAL)
Journal identifiersISSN: 1020-4989 • E-ISSN: 1680-5348
PublisherPan American Health Organization (PUBLISHER • US)
DOI10.26633/rpsp.2025.36
PMID40255650
OpenAlexW4409568481
LanguageEN
References cited14

Objective. To identify clinical characteristics and risk factors associated with mortality, with a focus on opportunistic infections (OIs), in patients with advanced HIV in Brazil. Methods. A prospective cohort study was conducted in five Brazilian tertiary hospitals, including 419 adults with advanced HIV. Baseline demographic and clinical data were collected during hospital admission, and participants were screened for tuberculosis, cryptococcosis, and histoplasmosis using rapid diagnostic tests. Participants were followed for 90 days to assess mortality, with causes of death classified using the Coding of Death in HIV (CoDe) protocol. Statistical analysis identified the variables associated with mortality. Results. The median CD4 count was 66 cells/mm3, and the median HIV viral load was 104 887 copies/mL. After 90 days, 18.1% of participants had died. ART-naive status, mental confusion, anemia, and elevated creatinine levels were strongly associated with mortality. OIs were diagnosed in 45.6% of participants, with severe histoplasmosis and cryptococcal meningitis significantly increasing the risk of mortality. Social determinants, such as sex, race, gender, and education level, did not have a significant impact on mortality, but socio­economic factors influenced health care access. Conclusion. Early HIV diagnosis and continuous ART are essential to reduce mortality. Public health strategies should prioritize improving HIV testing, treatment adherence, and addressing social disparities to mitigate health care inequalities

Cohort · Cohort study · Disease · Family medicine · Health care · Histoplasmosis · Human immunodeficiency virus (HIV · Mortality rate · Pathology · Prospective cohort study · Public health · Tuberculosis · Young adult · Demography · Fungal Infections and Studies · HIV/AIDS oral health manifestations · Medicine · Pneumocystis jirovecii pneumonia detection and treatment · Syphilis Diagnosis and Treatment · Immunology · Internal Medicine · Pediatrics

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