HIV-related deaths from selected infectious diseases among persons without AIDS in New Jersey

This study sought to quantify HIV-related deaths among persons not classified as having AIDS, in an area where AIDS incidence among injecting drug users (IDUs) is high. Death certificates of persons who were aged 25-44 years at death, died in 1987 in two New Jersey counties, and had certain infectious conditions were compared with names in the AIDS Registry. Hospital and/or Medical Examiner records were reviewed for nonmatching cases. Cases were considered as confirmed HIV infection if there was laboratory evidence of such infection and as suggestive HIV infection if the decedent had oral thrush or a combination of certain other clinical findings were present. Of 412 deaths meeting the above criteria, 165 (40.0%) were in the AIDS Registry. We investigated 205 of the remainder; of these, 7.3% were found to have AIDS, 21.5% had confirmed HIV infection without AIDS, and 15.1% had suggestive HIV infection. This increased the HIV-related mortality in excess of deaths due to AIDS in this age group by 9.2% for confirmed HIV infections and 15.6% for both confirmed and suggestive HIV infections, with deaths among IDUs increasing 12.3% for confirmed HIV infections and 18.9% for both confirmed and suggestive HIV infections. Thus, in addition to AIDS indicator diseases, a variety of other infectious conditions can lead to death in HIV-infected persons, particularly in IDUs; however, the extent of such deaths may be less than previously described.