Catàleg general VIH/sida
Mortality rates and excess mortality among HIV positive persons according to age in Spain; 2004-2014
Resum
Background: Success of antiretroviral treatment (ART) has changed the distribution of causes of death among HIV positive patients and new causes of death have emerged, such as liver-related or non-AIDS-defining malignancies (NADM). We describe and compare the mortality rates and excess mortality rates according to age in HIV-positive persons in the Cohort of the Spanish AIDS Research Network (CoRIS) from 2004 untill 2014. Methods:CoRIS is a multicenter, open, prospective cohort of HIV infected patients naïve to ART at entry. We calculated: mortality rates (per 1000py) for overall and cause-specific death comparing aged </>=50 years and excess mortality rates (per 1000py) comparing overall and cause-specific- mortality with that of the general population of similar age and sex. Age was modelled as a time-dependent variable. Death was classified by modified CoDE procedures. Results: Overall, 347 deaths were recorded in 9,569 (34385 py of follow-up) persons, leading to a mortality rate of 10.09 per 1000py (CI95%:9.08-11.21). The proportion of total py aged >=50 years increased from 8.8% to 21.2%, from 2004 to 2014. The mortality rate ratio was 2.70 (CI95%:2.15-3.38) higher for patient aged >=50. Forty-three per cent of the total deaths were attributable to AIDS, followed by 14% due to NADM, 9% liver-related, 7% other infectious diseases, 3% cardiovascular and 12% for other causes and unknown respectively. For cause-specific deaths, the mortality rate was 4.33 (3.69-5.09) for AIDS-related, 1.40 (1.05-1.85) for NADM, 0.93 (0.66-1.32) for liver-related, 0.67 (0.44-1.01) for other infectious diseases and 0.26 (0.14-0.50) for cardiovascular. Mortality rate ratio was higher for patient =50 years for all-causes and for cause-specific death. The overall excess mortality rate was 8.81 (per 1000py) (CI95%:7.87-9.87), being 7.37 (6.44-8.44) for subjects<50 years and 16.65 (13.51-20.53) for = 50 years. For NADM, excess mortality rate was 0.46 (0.27-0.79) for <50 years and 2.79 (1.67-4.65) for = 50 years. For liver-related, it was 0.84 (0.56-1.25) for <50 years and 1.13 (0.50-2.52) for = 50 years. And finally, for other infectious diseases, it was 0.64 (0.43-0.98) for <50 years and 0.54 (0.33-0.89) for = 50 years. Conclusion:High overall mortality rate and excess mortality rate were observed in HIV-positive subjects, especially among older patients. By cause-specific, higher NADM mortality and excess mortality was observed in patients aged = 50. However no significant differences by age were detected by liver diseases, although it represents an important cause of death in these patients.
Autoria:
ALEJOS FERRERAS, Belén; HERNANDO SEBASTIÁN, Victoria; VICIANA FERNÁNDEZ, Pompeyo; MONTERO ALONSO, Marta; BERENGUER, Juan; RIVERO, Marta; ASENSI, Víctor; GARCÍA-FRAILE FRAILE, Lucio Jesús; GUTIÉRREZ RODERO, Félix; MORENO GUILLÉN, Santiago
Autoria institucional: CoRIS (Cohorte de la Red de Investigación en Sida) (España)
Autoria institucional: CoRIS (Cohorte de la Red de Investigación en Sida) (España)
Fitxa bibliogràfica
- Any de publicació:
- [2016]
- Descripció física:
- [1] p.
- Format:
- Fulletó
- Tipus de document:
- Col·loquis i ponències
- Notes:
- Póster presentado en el VIII Congreso Nacional Gesida y 10ª Reunión Docente de la Red de Investigación en Sida celebrado del 29 de noviembre al 2 de diciembre de 2016 en San Sebastián.