Tuğçe Şimşek Bozok, Gülden Ersöz, Damla Ertürk, Yeşim Taşova, Ilkay Karaoğlan, Irem Ece Darbaz, Dilara İnan, Mustafa Kemal Çelen, Çiğdem Mermutluoğlu, Mehmet Çabalak, Berfin Çirkin Doruk, Sibel Kuyugöz Gülbudak, Şafak Kaya, Selma Ateş, Handan Alay, Tuba Damar Çakırca, Ayhan Akbulut, Mehmet Ali Aşan
Despite advances in antiretroviral therapy (ART), mortality remains an important concern among people living with HIV (PLWH). This study described the causes of in-hospital death and compared AIDS-related and non-AIDS-related deaths among 138 adults PLWH who died during hospitalization at 12 tertiary-care HIV centers in Türkiye between 2014 and 2025. Demographic, clinical, and HIV-related data were collected from medical records. Causes of death were classified as AIDS-related or non-AIDS-related using ICD-10-coded diagnoses and CDC/WHO AIDS-defining conditions. Overall, 138 in-hospital deaths were analyzed. AIDS-related deaths accounted for 56.5%. The leading AIDS-related causes were Pneumocystis jirovecii pneumonia, toxoplasmic encephalitis, and tuberculosis, whereas sepsis and respiratory conditions predominated among non-AIDS-related deaths. AIDS-related deaths were characterized by lower CD4 cell counts and more frequent AIDS-defining illness at diagnosis. Smoking (OR = 7.23, 95% CI 1.07-48.75, p = 0.042) and AIDS-defining illness at diagnosis (OR = 6.18, 95% CI 1.18-32.32, p = 0.031) were independently associated with AIDS-related rather than non-AIDS-related in-hospital death. AIDS-related causes remain prominent among in-hospital deaths despite the ART era. Earlier HIV diagnosis, timely ART initiation, and optimized prevention and management of opportunistic infections and comorbidities are essential to improve outcomes.