May 7, 2014
This article was reported by Healio.
Healio reported on a study of causes of death among HIV-positive patients receiving antiretroviral therapy (ART). Researchers for the Antiretroviral Therapy Cohort Collaboration reviewed data on patients enrolled in 16 cohorts in Europe and North America. They evaluated and coded the causes of death for the participants who had died and analyzed patient characteristics, time from beginning ART to death, AIDS-defining conditions after ART, and most recent CD4 count.
Of 65,121 patients, 4,237 died, for a mortality rate of 12.9 deaths per 1,000 person-years. Of these, 1,496 died of AIDS, 461 died of a non-AIDS malignancy, and 349 of unnatural causes. Mortality rate decreased from 24.3 per 1,000 person-years in the first 6 months of ART to 10.2 per 1,000 person-years after 5 years of ART for all causes. The decrease is due to fewer AIDS-related deaths, which went from 13.2 per 1,000 person-years in the first 6 months of ART to 2.4 per 1,000 person-years after 5 years.
Results show that cause of death varied based on age, sex, and transmission risk. In the first year of ART, data associated HIV transmission from injection drug use with higher rates of all causes of death compared with men who have sex with men. Also, data associated older age with death from cardiovascular diseases and non-AIDS malignancies. The researchers concluded that further study is required to determine which of various factors connected to HIV or ART are responsible for the results or whether the results are due to aging and non-HIV risk factors. They also suggested larger studies to compare age-standardized mortality rates and risk factors for HIV-positive and -negative populations.
The full report, "Impact of Risk Factors for Specific Causes Death in the First and Subsequent Years of ART Among HIV-Infected Patients," was published online in the journal Clinical Infectious Diseases (2014; doi: 10.1093/cid/ciu261).
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