IMMEDIATE CAUSES OF DEATH IN ACQUIRED IMMUNODEFICIENCY SYNDROME

  • 1 January 1985
    • journal article
    • research article
    • Vol. 109  (8) , 735-738
Abstract
The immediate causes of death were evaluated in 54 adults who underwent an autopsy and were diagnosed as having died of the acquired immunodeficiency syndrome between April 1980 and Oct. 1983. The study group included 25 Haitians, 19 homosexual men, 5 i.v. drug abusers, 2 hemophiliacs (type A), and 3 with no known risk. Fourteen died of CNS diseases: 11 of Toxoplasma encephalitis, 1 of progressive multifocal leukoencephalopathy, 1 of viral encephalitis, and 1 of intracerebral hemorrhage. Thirty died of respiratory failure; 16 of Pneumocystis carinii pneumonia, 10 of cytomegalovirus pneumonia, 1 of multiple infections, 1 of interstitial pneumonia, and 2 of bacterial pneumonia. Two died of overwhelming generalized infections: 1 of Mycobacterium avium-intracellulare and 1 of listeriosis. Six died of disseminated Kaposi''s sarcoma. The remaining 2 persons died of Toxoplasma myocarditis (1) and 1 of stock resulting from a percutaneous liver biopsy, respectively. There were differences in the immediate causes of death between Haitians and homosexuals as follows: 63% of homosexual men died of either P. carinii pneumonia or Kaposi''s sarcoma vs. 20% of Haitians. In contrast, 72% of Haitians died of other opportunistic infections as compared with 21% of homosexuals. There has not been an increase in the proportions of cases diagnosed premortem since 1982 and overall, only 32 (58%) were diagnosed premortem; the rest were diagnosed only at autopsy. This study provided evidence that 42% died of currently untreatable diseases.