The importance of outpatient screening of co-morbidities in adults living with HIV

Aim. To enhance outpatient screening methods for detecting comorbid conditions in adults living with HIV (ALHIV).

Materials and methods. The study analyzed official HIV statistics from Dushanbe for the period 2020– 2023, focusing on the adult population living with HIV. Key indicators assessed included the coverage of antiretroviral therapy (ART), patient mortality rates, and associated factors. Data were examined using descriptive statistical methods, and statistical significance of observed differences was determined by the chi-squared test (χ²).

Results and discussion. ART coverage among ALHIV in Dushanbe was 83.1% in 2020 and 82.3% in 2023 (p>0.05), indicating stagnation over the period analyzed. However, mortality rates significantly decreased from 2.8 per 100 ALHIV in 2020 to 1.8 per 100 ALHIV in 2023 (p<0.05). Analysis of cumulative mortality data (2020–2023), with known causes of death, revealed that comorbid (non-HIV related) diseases represented 75.4% of deaths, significantly surpassing HIV-related causes (24.6%; p=0.005). Among comorbidities causing death, liver cirrhosis was most common (29.8%), followed by cardiovascular diseases (26.9%), tuberculosis (15.4%), and various malignancies (11.5%).

Conclusions. 1) Antiretroviral therapy significantly reduces mortality from HIV-related conditions among ALHIV. 2) To address stagnation in ART coverage, continued integration of HIV care within primary health care systems is essential, improving accessibility and adherence to treatment. 3) The predominance of comorbid diseases as causes of death underscores the necessity for optimized outpatient screening protocols for early identification and management of these conditions.

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