Published in:
01-02-2011 | Clinical and Epidemiological Study
Causes of death and risk factors among HIV-infected persons in the HAART era: analysis of a large urban cohort
Authors:
S. Leone, G. Gregis, G. Quinzan, D. Velenti, G. Cologni, L. Soavi, V. Ravasio, D. Ripamonti, F. Suter, F. Maggiolo
Published in:
Infection
|
Issue 1/2011
Login to get access
Abstract
Objective
We aimed to examine the clinical outcome in HIV-1-infected patients after more than 10 years of highly active antiretroviral therapy (HAART).
Methods
We analyzed data from 1,236 treatment-naïve adults who had started HAART. The primary endpoint was the yearly prevalence of death for AIDS-related causes (ARC) or for non-AIDS related causes (non-ARC). The data from our cohort were compared with that of the general population (GP) of our region.
Results
We observed that 116 patients died, and 58.6% of deaths were non-ARC. The death incidence decreased from 18.8% in 1998–1999 to 1.2% in 2008–2009. The leading causes of death were malignancies (35.3%), infections (21.6%), end-stage liver diseases (18.1%), and cardiovascular diseases (CVD) (6.9%). Yearly death rates were similar in the HIV-infected cohort and in the crude GP (odds ratio [OR] 1.1, 95% confidence interval [CI] 0.5–2.5), but when adjusted for age, HIV-infected patients showed a greater risk (OR 7.4, 95% CI 4.1–13.4). The difference was still highly significant when the analysis was restricted to non-ARCs (OR 4.3, 95% CI 2.07–9.2). Overall, malignancies (OR 5.7, 95% CI 2.6–12.8) and end-stage liver diseases (OR 35.0, 95% CI 15.5–78.8) were significantly more frequent than in the age-adjusted GP.
Conclusions
Despite HAART, HIV-infected patients are at greater risk of death compared to a reference uninfected population.