Changes in the cause of death among HIV positive subjects across Europe: results from the EuroSIDA study

Details

Serval ID
serval:BIB_694830ABD75F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Changes in the cause of death among HIV positive subjects across Europe: results from the EuroSIDA study
Journal
AIDS
Author(s)
Mocroft  A., Brettle  R., Kirk  O., Blaxhult  A., Parkin  J. M., Antunes  F., Francioli  P., D'Arminio Monforte  A., Fox  Z., Lundgren  J. D.
ISSN
0269-9370 (Print)
Publication state
Published
Issued date
08/2002
Volume
16
Number
12
Pages
1663-71
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Aug 16
Abstract
OBJECTIVES: The causes of death among HIV-positive patients may have changed since the introduction of highly active antiretroviral therapy (HAART). We investigated these changes, patients who died without an AIDS diagnosis and factors relating to pre-AIDS deaths. METHODS: Analyses of 1826 deaths among EuroSIDA patients, an observational study of 8556 patients. Incidence rates of pre-AIDS deaths were compared to overall rates. Factors relating to pre-AIDS deaths were identified using Cox regression. RESULTS: Death rates declined from 15.6 to 2.7 per 100 person-years of follow-up (PYFU) between 1994 and 2001. Pre-AIDS incidence declined from 2.4 to 1.1 per 100 PYFU. The ratio of overall to pre-AIDS deaths peaked in 1996 at 8.4 and dropped to < 3 after 1998. The adjusted odds of dying following one AIDS defining event (ADE) increased yearly (odds ratio, 1.53; P < 0.001), conversely the odds of dying following three or more ADE decreased yearly (odds ratio, 0.79; P < 0.001). The proportion of deaths that followed an HIV-related disease decreased by 23% annually; in contrast there was a 32% yearly increase in the proportion of deaths due to known causes other than HIV-related or suicides. Injecting drug users (IDU) were significantly more likely to die before an ADE than homosexuals (relative hazard, 2.97; P < 0.0001) and patients from northern/eastern Europe (relative hazard, 2.01; P < 0.0001) were more likely to die pre-AIDS than southern patients. CONCLUSIONS: The proportion of pre-AIDS deaths increased from 1994 to 2001; however, the incidence of pre-AIDS deaths and deaths overall declined. IDU and subjects from northern/eastern Europe had an increased risk of pre-AIDS death. HIV-positive patients live longer therefore it is essential to continue to monitor all causes of mortality to identify changes.
Keywords
*Cause of Death Europe/epidemiology Female HIV Infections/complications/*mortality Humans Incidence Male
Pubmed
Web of science
Create date
25/01/2008 17:07
Last modification date
20/08/2019 14:24
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