作者
SW Worm, N Friis-Moller, CA Sabin, A Sjol, JD Lundgren, R Salbol-Brandt, M Rickenbach, P Pezzotti, E Krum, L Gras, E Balestre, A Sundstroem, M Delforge, E Fontas, F Torres, K Petoumenos, J Kjaer, S Collins, S Storpher, G Pearce, R Rode, I Weller
发表日期
2010/6/19
期刊
AIDS
卷号
24
期号
10
页码范围
1537-1548
出版商
LIPPINCOTT WILLIAMS & WILKINS
简介
Objective
To investigate any emerging trends in causes of death amongst HIV-positive individuals in the current cART era, and to investigate the factors associated with each specific cause of death.
Design
An observational multicentre cohort study.
Methods
All HIV-positive individuals included in one of the cohorts in the Data Collection on Adverse Events of Anti-HIV drugs (D: A: D) Study were included. The association between HIV-specific and non HIV-specific risk factors and death were studied using multivariable Poisson regression.
Results
We observed 2482 deaths in 180 176 person-years (PY) on 33 308 individuals [rate/1000 PY= 13.8 (95% CI 13.2-14.3)]. Primary causes of death were: AIDS (n= 743; rate/1000 PY= 4.12), liver-related (341; 1.89), CVD-related (289; 1.60), non-AIDS malignancy (286; 1.59). The overall rate of death fell from 16.9 in 1999/2000 to 9.6/1000 PY in 2007/2008. Smoking was associated with CVD and non-AIDS cancers, HBV and HCV co-infection with liver-related deaths, and hypertension with liver-related and CVD deaths. Diabetes was a risk factor for all specific causes of death except non-AIDS cancers, and higher current HIV RNA for AIDS-related deaths. Lower CD4 cell counts were associated with a higher risk of death from all specific causes of death.
Conclusion
Multiple potentially modifiable traditional and HIV-specific risk factors for death of HIV-infected persons were identified. The maximum reduction in mortality in HIV-infected populations will require that each of these factors be appropriately addressed. No trends in terms of emerging causes of unexpected deaths were observed, although monitoring …
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