Universität zu Köln

Ingle, Suzanne M., May, Margaret T., Gill, M. John, Mugavero, Michael J., Lewden, Charlotte, Abgrall, Sophie, Faetkenheuer, Gerd, Reiss, Peter, Saag, Michael S., Manzardo, Christian, Grabar, Sophie, Bruyand, Mathias, Moore, David, Mocroft, Amanda, Sterling, Timothy R., Monforte, Antonella D'Arminio, Hernando, Victoria ORCID: 0000-0003-2762-4924, Teira, Ramon, Guest, Jodie ORCID: 0000-0002-3650-3975, Cavassini, Matthias, Crane, Heidi M. and Sterne, Jonathan A. C. (2014). Impact of Risk Factors for Specific Causes of Death in the First and Subsequent Years of Antiretroviral Therapy Among HIV-Infected Patients. Clin. Infect. Dis., 59 (2). S. 287 - 298. CARY: OXFORD UNIV PRESS INC. ISSN 1537-6591

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Abstract

Background. Patterns of cause-specific mortality in individuals infected with human immunodeficiency virus type 1 (HIV-1) are changing dramatically in the era of antiretroviral therapy (ART). Methods. Sixteen cohorts from Europe and North America contributed data on adult patients followed from the start of ART. Procedures for coding causes of death were standardized. Estimated hazard ratios (HRs) were adjusted for transmission risk group, sex, age, year of ART initiation, baseline CD4 count, viral load, and AIDS status, before and after the first year of ART. Results. A total of 4237 of 65 121 (6.5%) patients died (median, 4.5 years follow-up). Rates of AIDS death decreased substantially with time since starting ART, but mortality from non-AIDS malignancy increased (rate ratio, 1.04 per year; 95% confidence interval [CI], 1.0-1.1). Higher mortality in men than women during the first year of ART was mostly due to non-AIDS malignancy and liver-related deaths. Associations with age were strongest for cardiovascular disease, heart/vascular, andmalignancy deaths. Patients with presumed transmission through injection drug use had higher rates of all causes of death, particularly for liver-related causes (HRs compared with men who have sex with men: 18.1 [95% CI, 6.2-52.7] during the first year of ART and 9.1 [95% CI, 5.8-14.2] thereafter). There was a persistent role of CD4 count at baseline and at 12 months in predicting AIDS, non-AIDS infection, and non-AIDS malignancy deaths. Lack of viral suppression on ART was associated with AIDS, non-AIDS infection, and other causes of death. Conclusions. Better understanding of patterns of and risk factors for cause-specific mortality in the ART era can aid in development of appropriate care for HIV-infected individuals and inform guidelines for risk factor management.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ingle, Suzanne M. UNSPECIFIED UNSPECIFIED UNSPECIFIED May, Margaret T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gill, M. John UNSPECIFIED UNSPECIFIED UNSPECIFIED Mugavero, Michael J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewden, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Abgrall, Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Faetkenheuer, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Reiss, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Saag, Michael S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Manzardo, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Grabar, Sophie UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruyand, Mathias UNSPECIFIED UNSPECIFIED UNSPECIFIED Moore, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Mocroft, Amanda UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterling, Timothy R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Monforte, Antonella D'Arminio UNSPECIFIED UNSPECIFIED UNSPECIFIED Hernando, Victoria UNSPECIFIED orcid.org/0000-0003-2762-4924 UNSPECIFIED Teira, Ramon UNSPECIFIED UNSPECIFIED UNSPECIFIED Guest, Jodie UNSPECIFIED orcid.org/0000-0002-3650-3975 UNSPECIFIED Cavassini, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Crane, Heidi M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sterne, Jonathan A. C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-433922
DOI:	10.1093/cid/ciu261
Journal or Publication Title:	Clin. Infect. Dis.
Volume:	59
Number:	2
Page Range:	S. 287 - 298
Date:	2014
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1537-6591
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HUMAN-IMMUNODEFICIENCY-VIRUS; GENERAL-POPULATION; LIFE EXPECTANCY; MORTALITY; COHORT; DIAGNOSIS; AIDS; PEOPLE; CANCER; ADULTS Multiple languages Immunology; Infectious Diseases; Microbiology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43392