Epidemiology

Despite the existence of highly effective and well-tolerated antiretroviral treatment (ART), opportunistic infections (OIs) still occur and result in an increased risk of mortality among people with AIDS. AIDS-related illnesses account for approximately 30% of deaths among persons with HIV.[4][5]​​​ The risk of OIs increases as the CD4 count declines.​​ In one study in New York City in 2000, 27.4% of patients newly diagnosed with AIDS had at least one OI, with the most frequent OIs being Pneumocystis jirovecii pneumonia (PCP) (12.2%) and Mycobacterium tuberculosis (TB) (5.3%). The main risk factors for having an OI were a late diagnosis of HIV infection, injection drug use, and older age.[6] In one multicenter study from France, among patients who died from AIDS-related complications, 27% died from at least one OI, with cytomegalovirus infection, PCP, disseminated M avium complex infection, and cerebral toxoplasmosis most commonly reported at the time of death.[7] Among those with AIDS-related deaths, HIV infection had been diagnosed recently in only 20% to 27% of patients.[7]​[8]​​​​

HIV-related illnesses caused an estimated 630,000 (480,000-880,000) deaths worldwide in 2022.[9]​ Worldwide, tuberculosis is the leading cause of morbidity and mortality among people with HIV.[1] In 2019, there were an estimated 217,000 (153,000-279,000) deaths due to tuberculosis among people with HIV and 1.15 million (1.01 to 1.32 million) incident cases.[10]

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