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
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
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 18:07
Last modification date
20/08/2019 15:24