Mortality for liver disease in patients with HIV infection: A cohort study

We undertook this study to assess the association between the various poten tial causes of liver disease in HIV-seropositive patients and mortality due to liver failure. Three hundred and eight in-hospital deaths were observed from 1987 to December 1995 in a prospectively followed cohort of 1894 HIV- seropositive patients. For each study subject, clinical data were evaluated to assess whether liver failure had substantially contributed to mortality . A case control study nested in the cohort was then performed, which compa red demographic and clinical variables observed at enrollment and during fo llow-up between patients who died for liver disease as the main or concurre nt cause of death (cases) and those who died as a result of illness related to AIDS or other causes (controls). Among 308 in-hospital deaths, liver fa ilure was found the cause of death in 35 patients (12%); in 16 cases, it wa s the primary cause and in 19 cases it was concurrent. Multivariate analysi s showed that in-hospital liver-disease-related mortality was independently associated with hepatitis B surface antigen reactivity (odds ratio [OR], 9 ; 95% confidence interval [CT], 3.8-21.7) and history of alcohol abuse (OR, 2.3; 95% CI, 1-5.2). Prevention and treatment of hepatitis B virus infecti on and alcohol intake are management priorities in HN-seropositive patients .