Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort
Garriga, César (Instituto de Salud Carlos III)
García de Olalla, Patricia (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Miró, Josep M. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Ocaña Rivera, Immaculada (Hospital Universitari Vall d'Hebron)
Knobel Freud, Hernando (Hospital del Mar (Barcelona, Catalunya))
Barberà, Maria Jesús (Hospital Universitari Vall d'Hebron)
Humet, Victoria (Generalitat de Catalunya. Direcció General de Serveis Penitenciaris i de Rehabilitació)
Domingo, Pere (Institut d'Investigació Biomèdica Sant Pau)
Gatell, Josep M.. (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Ribera, Esteve (Hospital Universitari Vall d'Hebron)
Gurguí, Mercè (Institut d'Investigació Biomèdica Sant Pau)
Marco, Andrés (Generalitat de Catalunya. Direcció General de Serveis Penitenciaris i de Rehabilitació)
Caylà, Joan A.. (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)

Fecha:	2015
Resumen:	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. 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. 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)]. 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) versus MSM. There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.
Ayudas:	Instituto de Salud Carlos III 12/PEAC-06
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	PloS one, Vol. 10 (december 2015) , ISSN 1932-6203

DOI: 10.1371/journal.pone.0145701
PMID: 26716982

19 p, 1.1 MB

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