Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort
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. We...
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| Veröffentlicht in: | PloS one 2015-12, Vol.10 (12), p.e0145701 |
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| creator | Garriga, César García de Olalla, Patricia Miró, Josep M Ocaña, Inma Knobel, Hernando Barberá, Maria Jesús Humet, Victoria Domingo, Pere Gatell, Josep M Ribera, Esteve Gurguí, Mercè Marco, Andrés Caylà, Joan A |
| description | 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.
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.
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)].
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 |
| doi_str_mv | 10.1371/journal.pone.0145701 |
| format | Article |
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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.
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)].
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.
There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0145701</identifier><identifier>PMID: 26716982</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acquired immune deficiency syndrome ; Acquired Immunodeficiency Syndrome - mortality ; Adult ; AIDS ; Analysis ; Anti-HIV Agents - therapeutic use ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiretroviral Therapy, Highly Active - methods ; Care and treatment ; Cause of Death ; CD4 antigen ; Cohort Studies ; Confidence intervals ; Death ; Drug Users - psychology ; Female ; Health risks ; Heterosexuality - psychology ; Highly active antiretroviral therapy ; HIV ; HIV infections ; HIV Infections - drug therapy ; HIV Infections - etiology ; HIV Infections - mortality ; Homosexuality, Male - psychology ; Human immunodeficiency virus ; Humans ; Intravenous administration ; Kaplan-Meier Estimate ; Male ; Males ; Medical diagnosis ; Mortality ; Risk analysis ; Risk Factors ; Sexually transmitted diseases ; Spain ; STD ; Substance Abuse, Intravenous - complications ; Survival</subject><ispartof>PloS one, 2015-12, Vol.10 (12), p.e0145701</ispartof><rights>COPYRIGHT 2015 Public Library of Science</rights><rights>2015 Garriga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2015 Garriga et al 2015 Garriga et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-61e7922f36ff5a720c1de7abc2047a770c23bc2b7ff8515301c7f9237288bcf13</citedby><cites>FETCH-LOGICAL-c692t-61e7922f36ff5a720c1de7abc2047a770c23bc2b7ff8515301c7f9237288bcf13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696823/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696823/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26716982$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Garriga, César</creatorcontrib><creatorcontrib>García de Olalla, Patricia</creatorcontrib><creatorcontrib>Miró, Josep M</creatorcontrib><creatorcontrib>Ocaña, Inma</creatorcontrib><creatorcontrib>Knobel, Hernando</creatorcontrib><creatorcontrib>Barberá, Maria Jesús</creatorcontrib><creatorcontrib>Humet, Victoria</creatorcontrib><creatorcontrib>Domingo, Pere</creatorcontrib><creatorcontrib>Gatell, Josep M</creatorcontrib><creatorcontrib>Ribera, Esteve</creatorcontrib><creatorcontrib>Gurguí, Mercè</creatorcontrib><creatorcontrib>Marco, Andrés</creatorcontrib><creatorcontrib>Caylà, Joan A</creatorcontrib><creatorcontrib>Barcelona HIV/AIDS working group</creatorcontrib><creatorcontrib>on behalf of Barcelona HIV/AIDS working group</creatorcontrib><title>Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>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.
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.
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)].
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.
There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.</description><subject>Acquired immune deficiency syndrome</subject><subject>Acquired Immunodeficiency Syndrome - mortality</subject><subject>Adult</subject><subject>AIDS</subject><subject>Analysis</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Care and treatment</subject><subject>Cause of Death</subject><subject>CD4 antigen</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Drug Users - psychology</subject><subject>Female</subject><subject>Health risks</subject><subject>Heterosexuality - psychology</subject><subject>Highly active antiretroviral therapy</subject><subject>HIV</subject><subject>HIV infections</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - etiology</subject><subject>HIV Infections - mortality</subject><subject>Homosexuality, Male - psychology</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Males</subject><subject>Medical diagnosis</subject><subject>Mortality</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sexually transmitted diseases</subject><subject>Spain</subject><subject>STD</subject><subject>Substance Abuse, Intravenous - complications</subject><subject>Survival</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk99v0zAQxyMEYqPwHyCwhIRAosU_Ejt5QSqFsUpFQwP2al0cu02VxsV2EPvvcdZsatAekB_sO3_ua_t8lyTPCZ4RJsj7re1cC81sb1s9wyTNBCYPklNSMDrlFLOHR-uT5In3W4wzlnP-ODmhXBBe5PQ0kV-tC9DU4fodWkDntUfWoE8awgZBW6G591bVEHSFzkAF6zy61E20UbAI0ArcWqPz5RX6Zvdd9Ne2nX4EH_GF3UTpp8kjA43Xz4Z5kvw8-_xjcT5dXXxZLuarqeIFDVNOtCgoNYwbk4GgWJFKCygVxakAIbCiLBqlMCbPSMYwUcIUlAma56UyhE2SlwfdfWO9HHLjJREZzXJGGYvE8kBUFrZy7-oduGtpoZY3DuvWElyoVaMlJUWJq6wCgtMUG1NwpQwmRJR59NAqan0YTuvKna6UboODZiQ63mnrjVzb3zLlBc9pf5k3g4Czvzrtg9zVXummgVbb7ubeLE3TLP7dJHn1D3r_6wZqDfEBdWtsPFf1onKeslzQKNhTs3uoOCq9q1UsJFNH_yjg7SggMkH_CetYKV4uv1_-P3txNWZfH7EbDU3YeNt0ff34MZgeQOWs906buyQTLPs-uM2G7PtADn0Qw14cf9Bd0G3hs78NGQBn</recordid><startdate>20151230</startdate><enddate>20151230</enddate><creator>Garriga, César</creator><creator>García de Olalla, Patricia</creator><creator>Miró, Josep M</creator><creator>Ocaña, Inma</creator><creator>Knobel, Hernando</creator><creator>Barberá, Maria Jesús</creator><creator>Humet, Victoria</creator><creator>Domingo, Pere</creator><creator>Gatell, Josep M</creator><creator>Ribera, Esteve</creator><creator>Gurguí, Mercè</creator><creator>Marco, Andrés</creator><creator>Caylà, Joan A</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20151230</creationdate><title>Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort</title><author>Garriga, César ; García de Olalla, Patricia ; Miró, Josep M ; Ocaña, Inma ; Knobel, Hernando ; Barberá, Maria Jesús ; Humet, Victoria ; Domingo, Pere ; Gatell, Josep M ; Ribera, Esteve ; Gurguí, Mercè ; Marco, Andrés ; Caylà, Joan A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-61e7922f36ff5a720c1de7abc2047a770c23bc2b7ff8515301c7f9237288bcf13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acquired immune deficiency syndrome</topic><topic>Acquired Immunodeficiency Syndrome - mortality</topic><topic>Adult</topic><topic>AIDS</topic><topic>Analysis</topic><topic>Anti-HIV Agents - therapeutic use</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Care and treatment</topic><topic>Cause of Death</topic><topic>CD4 antigen</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Death</topic><topic>Drug Users - psychology</topic><topic>Female</topic><topic>Health risks</topic><topic>Heterosexuality - psychology</topic><topic>Highly active antiretroviral therapy</topic><topic>HIV</topic><topic>HIV infections</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - etiology</topic><topic>HIV Infections - mortality</topic><topic>Homosexuality, Male - psychology</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Males</topic><topic>Medical diagnosis</topic><topic>Mortality</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sexually transmitted diseases</topic><topic>Spain</topic><topic>STD</topic><topic>Substance Abuse, Intravenous - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Garriga, César</au><au>García de Olalla, Patricia</au><au>Miró, Josep M</au><au>Ocaña, Inma</au><au>Knobel, Hernando</au><au>Barberá, Maria Jesús</au><au>Humet, Victoria</au><au>Domingo, Pere</au><au>Gatell, Josep M</au><au>Ribera, Esteve</au><au>Gurguí, Mercè</au><au>Marco, Andrés</au><au>Caylà, Joan A</au><aucorp>Barcelona HIV/AIDS working group</aucorp><aucorp>on behalf of Barcelona HIV/AIDS working group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2015-12-30</date><risdate>2015</risdate><volume>10</volume><issue>12</issue><spage>e0145701</spage><pages>e0145701-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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.
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.
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)].
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.
There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26716982</pmid><doi>10.1371/journal.pone.0145701</doi><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2015-12, Vol.10 (12), p.e0145701 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_1752583233 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Acquired immune deficiency syndrome Acquired Immunodeficiency Syndrome - mortality Adult AIDS Analysis Anti-HIV Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Antiretroviral Therapy, Highly Active - methods Care and treatment Cause of Death CD4 antigen Cohort Studies Confidence intervals Death Drug Users - psychology Female Health risks Heterosexuality - psychology Highly active antiretroviral therapy HIV HIV infections HIV Infections - drug therapy HIV Infections - etiology HIV Infections - mortality Homosexuality, Male - psychology Human immunodeficiency virus Humans Intravenous administration Kaplan-Meier Estimate Male Males Medical diagnosis Mortality Risk analysis Risk Factors Sexually transmitted diseases Spain STD Substance Abuse, Intravenous - complications Survival |
| title | Mortality, Causes of Death and Associated Factors Relate to a Large HIV Population-Based Cohort |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-10T11%3A28%3A35IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Mortality,%20Causes%20of%20Death%20and%20Associated%20Factors%20Relate%20to%20a%20Large%20HIV%20Population-Based%20Cohort&rft.jtitle=PloS%20one&rft.au=Garriga,%20C%C3%A9sar&rft.aucorp=Barcelona%20HIV/AIDS%20working%20group&rft.date=2015-12-30&rft.volume=10&rft.issue=12&rft.spage=e0145701&rft.pages=e0145701-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0145701&rft_dat=%3Cgale_plos_%3EA438727533%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1752583233&rft_id=info:pmid/26716982&rft_galeid=A438727533&rft_doaj_id=oai_doaj_org_article_219b0d5da10440ff96ccf0117b81042d&rfr_iscdi=true |