Causes of Death in HIV Patients and the Evolution of an AIDS Hospice : 1988–2008

Abstract EN

This paper reports on the transformation that has occurred in the care of people living with HIV/AIDS in a Toronto Hospice.

Casey House opened in the pre-HAART era to care exclusively for people with HIV/AIDS, an incurable disease.

At the time, all patients were admitted for palliative care and all deaths were due to AIDS-defining conditions.

AIDS-defining malignancies accounted for 22 percent of deaths, mainly, Kaposi sarcoma and lymphoma.

In the post-HAART era, AIDS-defining malignancies dropped dramatically and non-AIDS-defining malignancies became a significant cause of death, including liver cancer, lung cancer and gastric cancers.

In the post-HAART era, people living with HIV/AIDS served at Casey House have changed considerably, with increasing numbers of patients facing homelessness and mental health issues, including substance use.

Casey House offers a picture of the evolving epidemic and provides insight into changes and improvements made in the care of these patients.