Causes of deaths among persons infected with HIV in the Russian Federation in 2022–2023

Objective. Evaluation of the causes of death of patients with HIV infection in the Russian Federation (RF) in 2022–2023.

Materials and methods. An analysis of responses received from 89 regions of the Russian Federation to a special request from the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing on the causes of death of HIV-positive citizens in 2022–2023 was conducted.

Results. In 2022 and 2023, 32,425 and 32,321 deaths were registered among HIV-infected individuals, respectively; of which 1,362 and 1,498 were in the 4 reunited territories, respectively. The proportion of deaths coded by the B20–B24 (HIV infection) code remained unchanged: 41.5% in 2022 and 41.7% in 2023. Mycobacterial infection (B20.0) remained the most common cause of death in the Russian Federation, with a tendency for its proportion to decrease to 27.7% in 2023. Secondary diseases of viral etiology (B20.2 + B20.3), mycoses (B20.4 + B20.5), pneumocystis pneumonia (B20.6), other infectious and parasitic diseases, including cerebral toxoplasmosis (B20.8), led to death in 1.6-4.3% of cases. In 2022 and 2023, the Russian Federation recorded the same proportion of HIV-infected patients (52.2–52.9%), in whom death was caused by diseases not traditionally associated with HIV infection. The most common causes of death were cardiovascular diseases, gastroenterological diseases, injuries, poisoning and some other consequences of exposure to external causes. According to the data received from the 4 territories reunited with the Russian Federation, the etiological cause of death was established only in one third of patients, which is probably due to late detection of HIV infection, late hospitalization in a specialized hospital and initiation of treatment, as well as insufficient diagnostic capabilities of medical institutions and a small proportion of pathomorphological studies. In these territories, the proportion of PLHIV who died due to HIV infection was higher – 56.7 and 56.4%.

Conclusion. In 2022–2023, no significant decrease in the number of HIV-positive citizens who died per year and the proportion of patients among them who died from HIV-related diseases was detected in the territory of the Russian Federation, despite an increase in treatment coverage for patients undergoing follow-up care.