Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort
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 HIV-related 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 and
<200 CD4 at diagnosis versus ≥500 CD4.
Factors
associated with non-HIV-related causes of death include: ageing and heterosexual female versus MSM. Factors
associated with external causes of death were IDU male and heterosexual male versus MSM.
Below: Survival curves according to age, origin, educational level, transmission category, CD4, and anti-HCV antibodies.
By: Garriga C1,2, García de Olalla P1,3, Miró JM4, Ocaña I5, Knobel H6, Barberá MJ5, Humet V7, Domingo P8, Gatell JM4, Ribera E5, Gurguí M8, Marco A7, Caylà JA1,3; Barcelona HIV/AIDS working group.
- 1Epidemiology Service, Public Health Agency of Barcelona, Barcelona, Spain.
- 2Spanish Field Epidemiology Training Programme, National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain.
- 3CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
- 4Hospital Clinic- August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Barcelona, Spain.
- 5Infectious Diseases, Hospital Vall de Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
- 6Internal Medicine-Infectious Diseases, Hospital del Mar, Barcelona, Spain.
- 7Direcció General de Serveis Penitenciaris i de Rehabilitació, Departament de Justícia, Barcelona, Spain.
- 8Infectious Diseases Unit, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
- PLoS One. 2015 Dec 30;10(12):e0145701. doi: 10.1371/journal.pone.0145701
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