Morbidity and mortality in South African gold miners: impact of untreated disease due to human immunodeficiency virus

Clin Infect Dis. 2002 May 1;34(9):1251-8. doi: 10.1086/339540. Epub 2002 Apr 5.

Abstract

A cohort of 1792 human immunodeficiency virus (HIV)-positive and 2970 HIV-negative South African miners was observed for 12 months starting in February 1998. All-cause hospitalizations and deaths were significantly associated with HIV infection (respective unadjusted incidence rate ratios, 2.9 and 9.2; respective 95% confidence intervals, 2.5-3.4 and 5.5-16.0). Tuberculosis (TB), bacterial pneumonia, cryptococcosis, and trauma were the major causes of admission for HIV-positive patients, whereas Pneumocystis carinii pneumonia was an uncommon cause (respective admission rates, 8.5, 6.9, 2.2, 6.0, and 0.53 admissions per 100 person-years). Enteritis, bronchitis, urinary tract infections, and soft-tissue infections were also significantly associated with HIV infection. Cryptococcosis caused 44% of deaths among HIV-positive patients. Trauma was the main hazard for HIV-negative men, causing 42% of admissions and 60% of deaths. A broad range of infectious conditions is significantly associated with HIV infection in South African miners. Identification and implementation of effective prophylactic regimens are urgently needed.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Cost of Illness*
  • Gold
  • HIV
  • HIV Infections / economics
  • HIV Infections / epidemiology
  • HIV Infections / mortality*
  • Health Occupations
  • Hospitalization
  • Humans
  • Morbidity
  • Mortality
  • Prospective Studies
  • South Africa / epidemiology

Substances

  • Gold