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| Pàgina inicial > Articles > Articles publicats > Evolving AIDS- and non-AIDS Mortality and Predictors in the PISCIS Cohort of People Living With HIV in Catalonia and the Balearic Islands (Spain), 1998-2020 |
(Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol) (Institut de Recerca Sant Pau) (Institut d'Investigació Biomèdica de Bellvitge) (Hospital Universitari Son Llàtzer (Palma de Mallorca, Balears)) (Vall d'Hebron Institut de Recerca (VHIR)) (Hospital del Mar (Barcelona, Catalunya)) (Instituto de Salud Carlos III) (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública) (Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT))
| Data: | 2024 |
| Resum: | Background. Effective antiretroviral therapy (ART) has substantially reduced acquired immunodeficiency syndrome (AIDS)related deaths, shifting the focus to non-AIDS conditions in people living with human immunodeficiency virus (HIV) (PLWH). We examined mortality trends and predictors of AIDS- and non-AIDS mortality in the Population HIV Cohort from Catalonia and Balearic Islands (PISCIS) cohort of PLWH from 1998 to 2020. Methods. We used a modified Coding Causes of Death in HIV protocol, which has been widely adopted by various HIV cohorts to classify mortality causes. We applied standardized mortality rates (SMR) to compare with the general population and used competing risks models to determine AIDS-related and non-AIDS-related mortality predictors. Results. Among 30 394 PLWH (81. 5% male, median age at death 47. 3), crude mortality was 14. 2 per 1000 person-years. All-cause standardized mortality rates dropped from 9. 6 (95% confidence interval [CI], 8. 45-10. 90) in 1998 through 2003 to 3. 33 (95% CI, 3. 14-3. 53) in 2015 through 2020, P for trend =. 0001. Major causes were AIDS, non-AIDS cancers, cardiovascular disease, AIDS-defining cancers, viral hepatitis, and nonhepatitis liver disease. Predictors for AIDS-related mortality included being aged ≥40 years, not being a man who have sex with men, history of AIDS-defining illnesses, CD4 < 200 cells/µL, ≥2 comorbidities, and nonreceipt of ART. Non-AIDS mortality increased with age, injection drug use, heterosexual men, socioeconomic deprivation, CD4 200 to 349 cells/µL, nonreceipt of ART, and comorbidities, but migrants had lower risk (adjusted hazard risk, 0. 69 [95% CI,. 57-. 83]). Conclusions. Mortality rates among PLWH have significantly decreased over the past 2 decades, with a notable shift toward non-AIDS-related causes. Continuous monitoring and effective management of these non-AIDS conditions are essential to enhance overall health outcomes. |
| Ajuts: | Fundació la Marató de TV3 202117-30-31 |
| Drets: | 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.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | AIDS ; Antiretroviral therapy ; HIV ; Mortality ; Non-aids cancers |
| Publicat a: | Open Forum Infectious Diseases, Vol. 11 Núm. 4 (january 2024) , p. ofae132, ISSN 2328-8957 |
