Título:
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Mortality, Causes of Death and Associated Relate to a Large HIV Population-Based Cohort
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Autor/a:
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Garriga, César; García de Olalla, Patricia; Miró Meda, José M.; Ocaña, Inma; Knobel, Hernando; Barberá, Maria Jesús; Humet, Victoria; Domingo, Pere (Domingo Pedrol); Gatell, José M.; Ribera, Esteban; Gurguí, Mercè; Marco, Andrés; Caylà i Buqueras, Joan A.
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Otros autores:
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Universitat de Barcelona |
Abstract:
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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. |
Materia(s):
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-VIH (Virus) -Mortalitat -Epidemiologia -Antiretrovirals -HIV (Viruses) -Mortality -Epidemiology -Antiretroviral agents |
Derechos:
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cc-by (c) Garriga, César et al., 2015
http://creativecommons.org/licenses/by/3.0/es |
Tipo de documento:
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Artículo Artículo - Versión publicada |
Editor:
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Public Library of Science (PLoS)
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