Morbidity and mortality in the modern antiretroviral treatment era in a tertiary teaching hospital in Durban, South Africa.

Abstract Background Worldwide despite the availability of antiretroviral therapy, Human Immunodeficiency Virus / Acquired immunodeficiency syndrome still causes morbidity and mortality among patients. This study aimed at identifying the determinants of morbidity and mortality in the era of modern antiretroviral treatment (ART). Methods A retrospective study was conducted; data were obtained from medical records of all HIV infected patients admitted to King Edward medical wards from January to December 2018. This included demographic profile, clinical attributes and laboratory records. Data were analysed using R software where descriptive and inferential statistics were presented. The inferential statistics were five numbers summaries, box plot, Chi square, all fisher exact test and t test or rank some test. Results A total of 577 (50.6%) females and 564 (49.4%) males aged 12 years old and older infected by HIV were included in the study. The mean age of all the patients was 39.6 ± 12.2, 506 (44.3%) patients had CD4 less than 200 cells /mm3 and 273 (23.9%) had VL ˃ 1000 copies/ml. Association between CD4 cell count and Viral load (p˂ 0.05) was found. Male gender [OR 1.39(1.07–1.8) p = 0.015], Age [OR1.02 (1.01–1.03) p˂ 0.001], CD4 < 200 cells/mm3 [OR 2.14(1.37–3.45) p = 0.001], VL ˃ 1000 copies/ml [OR 1.93(1.08–3.63) p = 0.032] were associated with mortality in our cohort. Tuberculosis was the most common diagnosis on admission and the leading cause of death. Conclusion These findings illustrate that advanced HIV disease remains significant among inpatients despite the roll-out of ART. There is a need for raising the awareness of early appropriate treatment.