ORIGINAL RESEARCH
Infectious Diseases
doi: 10.25005/2074-0581-2026-28-1-29-37
PREDICTORS OF EARLY MORTALITY AMONG PEOPLE LIVING WITH HIV IN SUGHD REGION, TAJIKISTAN: A 2014-2023 COHORT STUDY

E.A. QURBONOV1,2

1Center for HIV Prevention and Control in Sughd region, Khujand, Republic of Tajikistan
2Department of Epidemiology, Hygiene and Environmental Protection with a Course of Microbiology and Virology, Institute of Postgraduate Education in Health Care of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan

Objective: To analyze predictors driving early mortality among registered HIV patients of the Sughd region, the Republic of Tajikistan.

Methods: A retrospective cohort study was conducted among deceased patients with laboratory-confirmed HIV infection from January 1, 2014, to December 31, 2023, across 17 AIDS centers in the Sughd region. The study took place from October 2024 to February 2025. Data were collected from the national electronic surveillance system for HIV cases and verified with paper medical and laboratory records. Descriptive statistics summarized the characteristics of the study participants. Early mortality was defined as death within the first year after HIV diagnosis. A multivariate logistic regression model was used to identify predictors of early mortality. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated to assess the strength of the associations. The association was considered statistically significant at p < 0.05.

Results: During the study period, 2735 cases of HIV infection were registered, of which 577 (21%) individuals died, resulting in a mortality rate of 21.1 deaths per 1000 person-years of observation. Of these, 353 (13%) died within the first year after diagnosis. Among the 577 deceased patients, 71% (407) were men, with a median age of 42.9 years (median 42 years, interquartile range 36-50 years). A total of 437 (76%) individuals lived in rural areas. Among causes of death, opportunistic infections were associated with an increased risk of early mortality in univariate analysis (COR=1.50; 95% CI: 1.02-2.22, p=0.040). The multivariate logistic regression model showed that patients with stage IV HIV (AOR=3.37; 95% CI: 1.11-11.8, p=0.041), low CD4+ lymphocyte counts, specifically <350 cells/μL, (AOR=2.30; 95% CI: 1.01-5.61, p<0.05), and high viral load (≥1000 copies/mL) at the time of HIV detection (AOR=6.87; 95% CI: 3.46-14.3, p<0.001) had a significantly higher risk of early mortality.

Conclusion: The main predictors of early mortality were late HIV diagnosis (stages 3 and 4), low CD4+ counts, and high viral load at diagnosis. These findings emphasize the importance of early HIV detection, prompt start of antiretroviral therapy, and increased public awareness of HIV, which can help decrease early mortality among people living with HIV.

Keywords: HIV infection, early mortality, causes of death, retrospective studies, logistic models, Tajikistan.

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Authors' information:

Qurbonov Emomali Abduvalievich,
Head of the Epidemiological Department of the Center for HIV Prevention and Control in Sughd region; Applicant of the Department of Epidemiology, Hygiene and Environmental Protection with a course of Microbiology and Virology, Institute of Postgraduate Education in Health Care of the Republic of Tajikistan
ORCID ID: 0009-0002-8002-8531
E-mail: emomali-kurbonov@mail.ru

Information about support in the form of grants, equipment, medications

The author did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Qurbonov Emomali Abduvalievich
Head of the Epidemiological Department of the Center for HIV Prevention and Control in Sughd region; Applicant of the Department of Epidemiology, Hygiene and Environmental Protection with a course of Microbiology and Vi- rology, Institute of Postgraduate Education in Health Care of the Republic of Tajikistan

735700, Republic of Tajikistan, Khujand, 34 microdistrict, Eastern industrial zone

Tel.: +992 (777) 005593

E-mail: emomali-kurbonov@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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