Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18
Abstract Background Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it...
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| Veröffentlicht in: | European journal of public health 2024-10, Vol.34 (5), p.879-884 |
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| creator | Vallée, Alexandre Majerholc, Catherine Zucman, David Livrozet, Jean-Michel Laurendeau, Caroline Bouée, Stéphane Prevoteau du Clary, François |
| description | Abstract
Background
Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France.
Methods
Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models.
Results
During the 13 years of follow-up (2006–18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P |
| doi_str_mv | 10.1093/eurpub/ckae031 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11430913</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A813829030</galeid><oup_id>10.1093/eurpub/ckae031</oup_id><sourcerecordid>A813829030</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-c7c04c72d32990b9b5c3ef72dd69ac7bd4a26ff96c127a3defdf473c944d2df3</originalsourceid><addsrcrecordid>eNqFkk1rFTEUhgdRbK1uXUrAjUKnTXIyH3EjpVhbqLop4i7k5qM3dSa5TTJKd_0Fblz59_pLzOWOpUpBssjHed43nMNbVc8J3iOYw76Z4mpa7Kuv0mAgD6ptwlpWQ4u_PCxngklNaEu3qicpXWCMm66nj6st6BnmvIXt6seHELMcXL5C0mukwhjiwmmXnUnIeSTRR5ld8N-dNqW6LDQKFh2ffK6dt0Zlo5HU05DTm7V4JaNLwaMcinKUWS1L3QdfF8HM3Vz_mo120VGUXpldRDFub65_kv5p9cjKIZln875TnR29Ozs8rk8_vT85PDitFcNNrlWnMFMd1UA5xwu-aBQYW-665VJ1C80kba3lrSK0k6CN1ZZ1oDhjmmoLO9XbjW2Z3Wi0Mj5HOYhVdKOMVyJIJ_6ueLcU5-GbIIQB5gSKw6vZIYbLyaQsRpeUGQbpTZiSoBwoAyA9LujLf9CLMEVf2hNACLC2b5o71LkcjCizDeVjtTYVBz2BnnIMa2rvHqosbUangjfWlff7BCqGlKKxt00SLNYJEpsEiTlBRfDi7mhu8T-RKcDrDRCm1f_MfgNskdQT</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3113468550</pqid></control><display><type>article</type><title>Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>PAIS Index</source><source>Access via Oxford University Press (Open Access Collection)</source><source>Alma/SFX Local Collection</source><creator>Vallée, Alexandre ; Majerholc, Catherine ; Zucman, David ; Livrozet, Jean-Michel ; Laurendeau, Caroline ; Bouée, Stéphane ; Prevoteau du Clary, François</creator><creatorcontrib>Vallée, Alexandre ; Majerholc, Catherine ; Zucman, David ; Livrozet, Jean-Michel ; Laurendeau, Caroline ; Bouée, Stéphane ; Prevoteau du Clary, François</creatorcontrib><description>Abstract
Background
Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France.
Methods
Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models.
Results
During the 13 years of follow-up (2006–18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P < 0.001). The over-mortality of PLWHIV was expressed by univariable HR = 2.135 (2.072–2.199), which remained significant after adjustment for region, Complementary Universal Health Insurance and AME, with multivariable HR = 2.182 (2.118–2.248). The results remained significant after adjusting for comorbidities, including infectious diseases [HR = 1.587 (1.538–1.638)]. Notably, PLWHIV were more importantly associated with mortality in women [HR = 2.966 (2.767–3.180)], compared in men [HR = 1.961 (1.898–2.027)].
Conclusion
Although the life expectancy of PLWHIV has globally increased, the causes of death should be prioritized in prevention policies and care management. Gender-specific policies should be highlighted, as we observed a higher impact of HIV mortality in women.</description><identifier>ISSN: 1101-1262</identifier><identifier>ISSN: 1464-360X</identifier><identifier>EISSN: 1464-360X</identifier><identifier>DOI: 10.1093/eurpub/ckae031</identifier><identifier>PMID: 38409963</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Adults ; Age ; Aged ; Analysis ; Antiretroviral agents ; Antiretroviral therapy ; Antiviral agents ; Care and treatment ; Cohort Studies ; Comorbidity ; Complications and side effects ; Data systems ; Diagnosis ; Dosage and administration ; Fatalities ; Female ; France - epidemiology ; Gender ; Health care industry ; HIV ; HIV infection ; HIV Infections - drug therapy ; HIV Infections - epidemiology ; HIV Infections - mortality ; Human immunodeficiency virus ; Humans ; Infectious Diseases ; Laboratory tests ; Life expectancy ; Life span ; Male ; Medical treatment ; Men ; Middle Aged ; Morbidity ; Mortality ; National health insurance ; Policies ; Population studies ; Prescription drugs ; Proportional Hazards Models ; Regression analysis ; Regression models ; Risk factors ; Women</subject><ispartof>European journal of public health, 2024-10, Vol.34 (5), p.879-884</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of the European Public Health Association.</rights><rights>COPYRIGHT 2024 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c405t-c7c04c72d32990b9b5c3ef72dd69ac7bd4a26ff96c127a3defdf473c944d2df3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,781,785,865,886,1605,27871,27929,27930</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38409963$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vallée, Alexandre</creatorcontrib><creatorcontrib>Majerholc, Catherine</creatorcontrib><creatorcontrib>Zucman, David</creatorcontrib><creatorcontrib>Livrozet, Jean-Michel</creatorcontrib><creatorcontrib>Laurendeau, Caroline</creatorcontrib><creatorcontrib>Bouée, Stéphane</creatorcontrib><creatorcontrib>Prevoteau du Clary, François</creatorcontrib><title>Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18</title><title>European journal of public health</title><addtitle>Eur J Public Health</addtitle><description>Abstract
Background
Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France.
Methods
Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models.
Results
During the 13 years of follow-up (2006–18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P < 0.001). The over-mortality of PLWHIV was expressed by univariable HR = 2.135 (2.072–2.199), which remained significant after adjustment for region, Complementary Universal Health Insurance and AME, with multivariable HR = 2.182 (2.118–2.248). The results remained significant after adjusting for comorbidities, including infectious diseases [HR = 1.587 (1.538–1.638)]. Notably, PLWHIV were more importantly associated with mortality in women [HR = 2.966 (2.767–3.180)], compared in men [HR = 1.961 (1.898–2.027)].
Conclusion
Although the life expectancy of PLWHIV has globally increased, the causes of death should be prioritized in prevention policies and care management. Gender-specific policies should be highlighted, as we observed a higher impact of HIV mortality in women.</description><subject>Adult</subject><subject>Adults</subject><subject>Age</subject><subject>Aged</subject><subject>Analysis</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral therapy</subject><subject>Antiviral agents</subject><subject>Care and treatment</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Complications and side effects</subject><subject>Data systems</subject><subject>Diagnosis</subject><subject>Dosage and administration</subject><subject>Fatalities</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Gender</subject><subject>Health care industry</subject><subject>HIV</subject><subject>HIV infection</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - epidemiology</subject><subject>HIV Infections - mortality</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Infectious Diseases</subject><subject>Laboratory tests</subject><subject>Life expectancy</subject><subject>Life span</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Men</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>National health insurance</subject><subject>Policies</subject><subject>Population studies</subject><subject>Prescription drugs</subject><subject>Proportional Hazards Models</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Risk factors</subject><subject>Women</subject><issn>1101-1262</issn><issn>1464-360X</issn><issn>1464-360X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><sourceid>7TQ</sourceid><recordid>eNqFkk1rFTEUhgdRbK1uXUrAjUKnTXIyH3EjpVhbqLop4i7k5qM3dSa5TTJKd_0Fblz59_pLzOWOpUpBssjHed43nMNbVc8J3iOYw76Z4mpa7Kuv0mAgD6ptwlpWQ4u_PCxngklNaEu3qicpXWCMm66nj6st6BnmvIXt6seHELMcXL5C0mukwhjiwmmXnUnIeSTRR5ld8N-dNqW6LDQKFh2ffK6dt0Zlo5HU05DTm7V4JaNLwaMcinKUWS1L3QdfF8HM3Vz_mo120VGUXpldRDFub65_kv5p9cjKIZln875TnR29Ozs8rk8_vT85PDitFcNNrlWnMFMd1UA5xwu-aBQYW-665VJ1C80kba3lrSK0k6CN1ZZ1oDhjmmoLO9XbjW2Z3Wi0Mj5HOYhVdKOMVyJIJ_6ueLcU5-GbIIQB5gSKw6vZIYbLyaQsRpeUGQbpTZiSoBwoAyA9LujLf9CLMEVf2hNACLC2b5o71LkcjCizDeVjtTYVBz2BnnIMa2rvHqosbUangjfWlff7BCqGlKKxt00SLNYJEpsEiTlBRfDi7mhu8T-RKcDrDRCm1f_MfgNskdQT</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Vallée, Alexandre</creator><creator>Majerholc, Catherine</creator><creator>Zucman, David</creator><creator>Livrozet, Jean-Michel</creator><creator>Laurendeau, Caroline</creator><creator>Bouée, Stéphane</creator><creator>Prevoteau du Clary, François</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>TOX</scope><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>7T2</scope><scope>7TQ</scope><scope>C1K</scope><scope>DHY</scope><scope>DON</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20241001</creationdate><title>Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18</title><author>Vallée, Alexandre ; Majerholc, Catherine ; Zucman, David ; Livrozet, Jean-Michel ; Laurendeau, Caroline ; Bouée, Stéphane ; Prevoteau du Clary, François</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-c7c04c72d32990b9b5c3ef72dd69ac7bd4a26ff96c127a3defdf473c944d2df3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Adults</topic><topic>Age</topic><topic>Aged</topic><topic>Analysis</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral therapy</topic><topic>Antiviral agents</topic><topic>Care and treatment</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Complications and side effects</topic><topic>Data systems</topic><topic>Diagnosis</topic><topic>Dosage and administration</topic><topic>Fatalities</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Gender</topic><topic>Health care industry</topic><topic>HIV</topic><topic>HIV infection</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - epidemiology</topic><topic>HIV Infections - mortality</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Infectious Diseases</topic><topic>Laboratory tests</topic><topic>Life expectancy</topic><topic>Life span</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Men</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>National health insurance</topic><topic>Policies</topic><topic>Population studies</topic><topic>Prescription drugs</topic><topic>Proportional Hazards Models</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Risk factors</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vallée, Alexandre</creatorcontrib><creatorcontrib>Majerholc, Catherine</creatorcontrib><creatorcontrib>Zucman, David</creatorcontrib><creatorcontrib>Livrozet, Jean-Michel</creatorcontrib><creatorcontrib>Laurendeau, Caroline</creatorcontrib><creatorcontrib>Bouée, Stéphane</creatorcontrib><creatorcontrib>Prevoteau du Clary, François</creatorcontrib><collection>Access via Oxford University Press (Open Access Collection)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>PAIS Index</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vallée, Alexandre</au><au>Majerholc, Catherine</au><au>Zucman, David</au><au>Livrozet, Jean-Michel</au><au>Laurendeau, Caroline</au><au>Bouée, Stéphane</au><au>Prevoteau du Clary, François</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18</atitle><jtitle>European journal of public health</jtitle><addtitle>Eur J Public Health</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>34</volume><issue>5</issue><spage>879</spage><epage>884</epage><pages>879-884</pages><issn>1101-1262</issn><issn>1464-360X</issn><eissn>1464-360X</eissn><abstract>Abstract
Background
Human immunodeficiency virus (HIV) remains a significant cause of morbidity and mortality worldwide. The aim of this study was to describe the mortality rate and associated comorbidities in a nationwide population-based cohort of persons living with HIV (PLWHIV) and to compare it with mortality in an age and gender-matched cohort of non-HIV individuals in France.
Methods
Using data from the French national health data system, we identified and included 173 712 PLWHIV (66.5% men) and 173 712 non-HIV participants (66.5% men) matched for age and gender. PLHIV were identified based on ICD-10 HIV diagnoses, HIV-specific laboratory tests, and/or prescriptions for antiretroviral therapy specific to HIV. Hazard ratios (HRs) of mortality were assessed using multiple Cox regression models.
Results
During the 13 years of follow-up (2006–18), we observed 20 018 deaths among PLWHIV compared with 6262 deaths among non-HIV participants (11.52% vs. 3.60%, P < 0.001). The over-mortality of PLWHIV was expressed by univariable HR = 2.135 (2.072–2.199), which remained significant after adjustment for region, Complementary Universal Health Insurance and AME, with multivariable HR = 2.182 (2.118–2.248). The results remained significant after adjusting for comorbidities, including infectious diseases [HR = 1.587 (1.538–1.638)]. Notably, PLWHIV were more importantly associated with mortality in women [HR = 2.966 (2.767–3.180)], compared in men [HR = 1.961 (1.898–2.027)].
Conclusion
Although the life expectancy of PLWHIV has globally increased, the causes of death should be prioritized in prevention policies and care management. Gender-specific policies should be highlighted, as we observed a higher impact of HIV mortality in women.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>38409963</pmid><doi>10.1093/eurpub/ckae031</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Adults Age Aged Analysis Antiretroviral agents Antiretroviral therapy Antiviral agents Care and treatment Cohort Studies Comorbidity Complications and side effects Data systems Diagnosis Dosage and administration Fatalities Female France - epidemiology Gender Health care industry HIV HIV infection HIV Infections - drug therapy HIV Infections - epidemiology HIV Infections - mortality Human immunodeficiency virus Humans Infectious Diseases Laboratory tests Life expectancy Life span Male Medical treatment Men Middle Aged Morbidity Mortality National health insurance Policies Population studies Prescription drugs Proportional Hazards Models Regression analysis Regression models Risk factors Women |
| title | Mortality and comorbidities in a Nationwide cohort of HIV-infected adults: comparison to a matched non-HIV adults’ cohort, France, 2006–18 |
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