The structure of comorbidities in cases of fatal outcomes in HIV-infected patients held at reform facilities of the Federal Penitentiary Service of Russia

Aim. To study the structure of comorbidities in HIV-infected patients who died in institutions of the penal system. Materials and methods. The material of the study was the data of a retrospective analysis of 515 clinical cases with fatal outcomes from diseases in the institutions of the Federal Penitentiary Service of Russia in the Udmurt Republic from 2004 to October 2020. The study group (group I) consisted of 91 patients from among the persons infected with HIV, the control group (group II) - patients with HIV-negative status (424 patients). Statistical processing of the material was carried out using the methods of variation statistics. Significance was assessed using the Pearson Chi-square test (х2), Student's t test. During the study, the structure of concomitant diseases in cases of lethal outcomes was studied in dynamics. For the statistical processing of indicators and the implementation of a medium-term forecast (for three periods (years) ahead) of the values of the studied epidemiological indicators, the determination coefficient R2 was used. Results. As part of the in-depth analysis of mortality, it was proved that HIV-infected patients, unlike those with HIV-negative status, significantly more often suffer from diseases of the circulatory system (I00-I99), which were diagnosed on average in 47.1% of cases (х2=1 1.557, р<0.001), diseases of the digestive system (K00-K93) diagnosed on average in more than half (58.3%) of clinical cases (х2=12.829, р<0.001), diseases of the nervous system (G00-G99) diagnosed on average in 73.4% (х2=74.151, р<0.001), as well as diseases of the urinary system (N00-N99), diagnosed on average in 20.8% of patients (х2=7.993, р=0.005). With the implementation of the mid-term forecast, an increase in the structure of concomitant pathologies of diseases of the circulatory system (R2=0.4023) and diseases of the digestive system (R2=0.4807) is expected. The share of diseases of the nervous system will remain stably high (R2=0.3242). Conclusion. HIV-infected patients in penitentiary institutions are characterized by polymorbid conditions, which require timely diagnosis and therapy in order to reduce the risk of poor outcomes and disability.

HIV infection, mortality, penitentiary system