The Mortality of AIDS Patients in National AIDS Program In Chiangrai Regional Hospital

Abstract

      Since the first case of AIDS in Thailand in the year 1984, the mortality rate of HIV infected patients is increasing. Because of the immunodeficiency caused by HIV infection, the patients died from many opportunistic infections. Availability of antiretroviral drugs from monotherapy and dualtherapy at the beginning caused HIV drug resistance then the mortality rate still increased. Thai government provided Highly Active Anti-Retroviral Treatment (HAART) from the program of Access To Care (ATC), National Program for People living with HIV/AIDS (NAPHA) and now HAART is covered by National Health Security Organisation (National AIDS Program;NAP). Chiangrai Regional Hospital provided antiretroviral treatment (ART) since 2001 until now 1,404 patients are in NAP. The availability of ART decreased the mortality in AIDS patients but the mortality is still existed. Analysis of mortality has been done to find the common causes for further improvement of the dead rate. From January 2002 to April 2008, 153 of AIDS patients in the NAP died, 71(46.4%) from AIDS related illness, 45 (29.4%) from Non-AIDS conditions and 37 (24.1%) from unknown causes. The common opportunistic infections are tuberculosis (39 patients; 49.36% of AIDS related illness), cryptococcosis (9 patients), diarrhea (8 patients), penicilliosis and cerebral toxoplasmosis (5 patients for each). Non-AIDS conditions are 7 patients from suicide (6 hangings, 1 drug overdose), 4 over alcoholic drinkings and 3 carcinoma of cervix 103(67.3%) patients had CD4 < 50 cells/cu.mm. showed that the patients accessed to HIV care too late. In the next step, we will try to educate people to know more about HIV and the available of treatment. The disclosure issue is one of the problem of delay access too.