Estimation of Improvements in Mortality in Spectrum among Adults with HIV Receiving Antiretroviral Therapy in High-Income Countries
Trickey, Adam (University of Bristol)
Glaubius, R. (Avenir Health)
Pantazis, N. (National and Kapodistrian University of Athens)
Zangerle, R. (Medical University Innsbruck)
Wittkop, L. (Institut Bergonié)
Vehreschild, J. (Uniklinik Köln (Colònia, Alemanya))
Grabar, S. (St Antoine Hospital)
Cavassini, M. (Lausanne University Hospital)
Teira, R. (Hospital Universitario de Sierrallana)
D'Arminio Monforte, A. (University of Milan)
Casabona-Barbarà, Jordi (Institut Germans Trias i Pujol. Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya)
Van Sighem, A. (Stichting HIV Monitoring)
Jarrin, I. (Instituto de Salud Carlos III)
Ingle, S.M. (University of Bristol)
Sterne, J.A.C. (Health Data Research UK South-West)
Imai-Eaton, J.W. (Harvard T.H. Chan School of Public Health)
Johnson, L.F. (University of Cape Town)
Universitat Autònoma de Barcelona

Data:	2024
Resum:	Introduction: Mortality rates for people living with HIV (PLHIV) on antiretroviral therapy (ART) in high-income countries continue to decline. We compared mortality rates among PLHIV on ART in Europe for 2016-2020 with Spectrum's estimates. Methods: The AIDS Impact Module in Spectrum is a compartmental HIV epidemic model coupled with a demographic population projection model. We used national Spectrum projections developed for the 2022 HIV estimates round to calculate mortality rates among PLHIV on ART, adjusting to the age/country distribution of PLHIV starting ART from 1996 to 2020 in the Antiretroviral Therapy Cohort Collaboration (ART-CC)'s European cohorts. Results: In the ART-CC, 11,504 of 162,835 PLHIV died. Between 1996-1999 and 2016-2020, AIDS-related mortality in the ART-CC decreased from 8. 8 (95% CI: 7. 6 to 10. 1) to 1. 0 (0. 9-1. 2) and from 5. 9 (4. 4-8. 1) to 1. 1 (0. 9-1. 4) deaths per 1000 person-years among men and women, respectively. Non-AIDS-related mortality decreased from 9. 1 (7. 9-10. 5) to 6. 1 (5. 8-6. 5) and from 7. 0 (5. 2-9. 3) to 4. 8 (4. 3-5. 2) deaths per 1000 person-years among men and women, respectively. Adjusted all-cause mortality rates in Spectrum among men were near ART-CC estimates for 2016-2020 (Spectrum: 7. 02-7. 47 deaths per 1000 person-years) but approximately 20% lower in women (Spectrum: 4. 66-4. 70). Adjusted excess mortality rates in Spectrum were 2. 5-fold higher in women and 3. 1-3. 4-fold higher in men in comparison to the ART-CC's AIDS-specific mortality rates. Discussion: Spectrum's all-cause mortality estimates among PLHIV are consistent with age/country-controlled mortality observed in ART-CC, with some underestimation of mortality among women. Comparing results suggest that 60%-70% of excess deaths among PLHIV on ART in Spectrum are from non-AIDS causes.
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 mortality ; Excess mortality ; Modelling ; Parameters ; Europe ; High income
Publicat a:	Journal of acquired immune deficiency syndromes (1999), Vol. 95 Núm. 1 (january 2024) , p. S89-S96, ISSN 1944-7884

DOI: 10.1097/QAI.0000000000003326
PMID: 38180742

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