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
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)

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