Two-year HIV-1-associated mortality in a Ugandan rural population

• Published in: The Lancet (British edition) 1994-04, Vol.343 (8904), p.1021-1023
• Main Authors: Mulder, D.W., Nunn, A.J., Kamali, A., Nakiyingi, J., Wagner, H-U., Kengeya-Kayondo, J.F.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Factors; AIDS/HIV; Biological and medical sciences; Child; Child, Preschool; Female; HIV; HIV Antibodies - isolation & purification; HIV Infections - epidemiology; HIV Infections - mortality; HIV Seropositivity - epidemiology; HIV Seropositivity - mortality; HIV Seroprevalence; HIV-1 - isolation & purification; Human immunodeficiency virus; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Infant; Male; Medical sciences; Middle Aged; Mortality; Patients; Prospective Studies; Rural areas; Rural Health; Rural populations; Uganda
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(94)90133-3

The mortality in 15 villages in South-West Uganda was studied in relation to HIV infection. After a population census, serum samples were tested for antibodies to HIV-1. Deaths were ascertained over 2 years. Unequivocal HIV-1 serology results were available for 9389 individuals. The prevalence of infection was 4·8% for all ages and 8·2% for adults (aged 13 or more). 198 deaths were recorded during 15 725 person years of observation. Mortality among seronegative adults was 7 7 per 1000 and among seropositive adults 115·9 per 1000. The excess annual death rate associated with HIV-1 infection was 5 3 per 1000 and in adults 7 9 per 1000. Highest excess mortality was 16 9 per 1000 in the age group 25-34. Among adults, half of all deaths and among those aged 13-44 over 80% of deaths were attributable to HIV-1 infection. These results show the strong impact that HIV-1 infection is having on mortality in a rural area of Uganda where the overall HIV-1 adult prevalence rate is below 10%—a rate lower than in many other parts of East Africa.