Catàleg general VIH/sida
Mortality, causes of death and associated relate to a large HIV population-based cohort
Resum
Introduction: Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods: We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results: 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0–16.1/1000 py], 81.3%of them had a known cause of death. Mortality rate by HIVrelated causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7–6.1/1000 py), external was lower [1.7/1000 py; (1.0–2.4/1000 py)]. Survival Results: Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5–7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3–5.7) versus _500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4–1.7) and heterosexual female (sHR:2.8; CI:1.1–7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7–123.2) and heterosexual male (sHR:11.8; CI:2.5–56.4) versusMSM. Conclusion and Recommendation There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.
Autoria:
GARRIGA, César; GARCÍA DE OLALLA RIZO, Patricia; MIRÓ MEDA, José María; OCAÑA, Inmaculada; KNOBEL FREUD, Hernando; BARBERÁ GRACIA, María Jesús; HUMET, Victoria; DOMINGO PEDROL, Pere; GATELL ARTIGAS, Josep Maria; RIBERA, Esteve; GURGUÍ, Mercè; MARCO MOURIÑO, Andrés; CAYLÀ BUQUERAS, Joan Artur
Fitxa bibliogràfica
- Any de publicació:
- 2015
- Publicació:
- [S.l.] : Public Library of Science
- En:
- Número:
- Vol. 10, no. 12 : e0145701 (December 30, 2015), 19 p.
- Format:
- Article
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