Title : Mortality from HIV infection in russia before and during the covid-19 pandemic
Abstract:
Purpose of the study: To study the dynamics of mortality from HIV infection in Russia before and during the Covid-19 pandemic.
Materials and methods: Rosstat data on the number and causes of death of contingents with HIV infection for 2012-2021. For the analysis, the StatTech program (developed by Stattech Ltd, Russia) was used.
Results: In Russia, before the pandemic in 2012-2019 mortality from HIV infection increased by 2.2 times and in 2019 was 12.7 per 100 000 of the population (in 2012 - 5.8 per 100 000 of the population). The overall growth rate was high at 119%. Starting from 2019, mortality from HIV infection in Russia began to decline, and this trend continued during the pandemic (2020-2021): in 2021, its values decreased by 1.2 times compared to 2019 and amounted to 10.7 per 100 000 of the population, while the rate of decline was 15.7%. Before the pandemic in 2017 and 2019 in Russia, for the first time, a decrease in the number of contingents who died from HIV infection was recorded: in 2019, their number was 26869 people (in 2017 - 25981 people). During the pandemic (2020-2021), this trend continued and the number of deaths of contingents with HIV infection decreased by 4.2% and 8.3% compared to 2019 and amounted to 25750 and 24634 people respectively. Among patients whose cause of death was HIV infection (ICD-10 B20-B24), there was a gradual decrease in the proportion of patients with TB associated HIV infection (TB/HIV) before and during the pandemic. The largest proportion of TB/HIV patients among patients who died from HIV infection, which was 47.6%, was registered in 2014, when almost every second case of death from HIV infection was observed among TB/HIV patients. Starting from 2015, the proportion of TB/HIV patients began to gradually decrease and in 2019 its value reached 37.9%. Although this trend continued during the pandemic and in 2020 the proportion of TB/HIV patients among patients who died from HIV infection decreased to 34.8%, it was still high, i.e. in 2020 Every 3rd patient whose cause of death was HIV infection was a TB/HIV patient. The main factor that had a positive impact on the dynamics of mortality from HIV infection in Russia in recent years was an increase in the coverage of contingents with HIV infection with antiretroviral therapy (ARVT), whose share in 2020-2021 increased to 82.2% and 83.3% (in 2017 - 50.1%). As a result, the life expectancy of contingents with HIV infection has increased: in 2021 to 13 years (in 2019 - 8.5 years) and their number, which in 2021 was 749227 people. (in 2019 - 662208 people).
Conclusion: In Russia, a year before the start of the pandemic and during it, a decrease in mortality from HIV infection was observed due to a significant increase in the coverage of contingents with HIV infection with antiretroviral therapy. At the same time, the persistence of a high proportion of TB/HIV patients in the structure of the death rate from HIV infection will have a negative impact on the decrease in the values of this indicator, slowing down the pace of its decline.
