Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/103084
Title: Mortality, Causes of Death and Associated Relate to a Large HIV Population-Based Cohort
Author: Garriga, César
García de Olalla, Patricia
Miró Meda, José M.
Ocaña, Inma
Knobel, Hernando
Barberá, Maria Jesús
Humet, Victoria
Domingo, Pere (Domingo Pedrol)
Gatell, José M.
Ribera, Esteve
Gurguí, Mercè
Marco, Andrés
Caylà i Buqueras, Joan A.
Keywords: VIH (Virus)
Mortalitat
Epidemiologia
Antiretrovirals
HIV (Viruses)
Mortality
Epidemiology
Antiretroviral agents
Issue Date: 30-Dec-2015
Publisher: Public Library of Science (PLoS)
Abstract: 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 (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. Conclusion and Recommendation There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.
Note: Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0145701
It is part of: PLoS One, 2015, vol. 10, num. 12, p. e0145701
Related resource: http://dx.doi.org/10.1371/journal.pone.0145701
URI: http://hdl.handle.net/2445/103084
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (Medicina)

Files in This Item:
File Description SizeFormat 
660894.pdf1.11 MBAdobe PDFView/Open


This item is licensed under a Creative Commons License Creative Commons