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Care interruptions and mortality among adults in Europe and North America

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Název: Care interruptions and mortality among adults in Europe and North America
Autoři: Trickey, Adam, Zhang, Lei, Rentsch, Christopher T, Pantazis, Nikos, Izquierdo, Rebeca, Antinori, Andrea, Leierer, Gisela, Burkholder, Greer, Cavassini, Matthias, Palacio-Vieira, Jorge, Gill, M John, Teira, Ramon, Stephan, Christoph, Obel, Niels, Vehreschild, Jorg-Janne, Sterling, Timothy R, van der Valk, Marc, Bonnet, Fabrice, Crane, Heidi M, Silverberg, Michael J, Ingle, Suzanne M, Sterne, Jonathan A, Antiretroviral Therapy Cohort, Collaboration
Přispěvatelé: NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos), National Institute for Health Research (Reino Unido), Wellcome Trust, Gilead Sciences (Spain), Agence Nationale de Recherches sur le sida et les hépatites virales (Francia), Ministère de la Santé (Francia), Austrian Agency for Health and Food Safety, Stichting HIV Monitoring, Ministry of Health (Holanda), National Institute for Public Health and the Environment (Holanda), German Center for Infection Research (Alemania), RETICS-Sida (RIS-ISCIII) (España), Plan Nacional de I+D+i (España), Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), ViiV Healthcare UK, Preben og Anna Simonsens Fond, Institut National de la Santé et de la Recherche Médicale (Francia), Bristol-Myers Squibb, Janssen Cilag, Ministerio de Sanidad (España), CFAR Network of Integrated Clinical Systems (CNICS), Swiss National Science Foundation, United States Department of Veterans Affairs, NIH - National Institute of Allergy and Infectious Diseases (NIAID) (Estados Unidos), Antiretroviral Therapy Cohort Collaboration (ART-CC), Admin, Oskar
Zdroj: AIDS
Repisalud
Instituto de Salud Carlos III (ISCIII)
AIDS, vol. 38, no. 10, pp. 1533-1542
Informace o vydavateli: Ovid Technologies (Wolters Kluwer Health), 2024.
Rok vydání: 2024
Témata: Male, Adult, treatment gap, Treatment gap, Epidemiology and Social, Anti-HIV Agents, antiretroviral therapy, Humans, Female, North America/epidemiology, HIV Infections/mortality, HIV Infections/drug therapy, Europe/epidemiology, Middle Aged, Anti-HIV Agents/therapeutic use, Cohort Studies, Western Europe, HIV Infections, mortality, Antiretroviral therapy, Europe, 03 medical and health sciences, 0302 clinical medicine, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Adherence, North America, adherence, Mortality
Popis: Objective: Interruptions in care of people with HIV (PWH) on antiretroviral therapy (ART) are associated with adverse outcomes, but most studies have relied on composite outcomes. We investigated whether mortality risk following care interruptions differed from mortality risk after first starting ART. Design: Collaboration of 18 European and North American HIV observational cohort studies of adults with HIV starting ART between 2004 and 2019. Methods: Care interruptions were defined as gaps in contact of ≥365 days, with a subsequent return to care (distinct from loss to follow-up), or ≥270 days and ≥545 days in sensitivity analyses. Follow-up time was allocated to no/preinterruption or postinterruption follow-up groups. We used Cox regression to compare hazards of mortality between care interruption groups, adjusting for time-updated demographic and clinical characteristics and biomarkers upon ART initiation or re-initiation of care. Results: Of 89 197 PWH, 83.4% were male and median age at ART start was 39 years [interquartile range (IQR): 31–48)]. 8654 PWH (9.7%) had ≥1 care interruption; 10 913 episodes of follow-up following a care interruption were included. There were 6104 deaths in 536 334 person-years, a crude mortality rate of 11.4 [95% confidence interval (CI): 11.1–11.7] per 1000 person-years. The adjusted mortality hazard ratio (HR) for the postinterruption group was 1.72 (95% CI: 1.57–1.88) compared with the no/preinterruption group. Results were robust to sensitivity analyses assuming ≥270-day (HR 1.49, 95% CI: 1.40–1.60) and ≥545-day (HR 1.67, 95% CI: 1.48–1.88) interruptions. Conclusions: Mortality was higher among PWH reinitiating care following an interruption, compared with when PWH initially start ART, indicating the importance of uninterrupted care.
Druh dokumentu: Article
Other literature type
Popis souboru: application/pdf
Jazyk: English
ISSN: 1473-5571
0269-9370
DOI: 10.1097/qad.0000000000003924
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38742863
https://hdl.handle.net/20.500.12105/25435
https://pure.amsterdamumc.nl/en/publications/4640ec93-2953-41a1-8857-067658bcc16a
https://doi.org/10.1097/QAD.0000000000003924
https://serval.unil.ch/notice/serval:BIB_1DF06B603132
http://nbn-resolving.org/urn/resolver.pl?urn=urn:nbn:ch:serval-BIB_1DF06B6031324
https://serval.unil.ch/resource/serval:BIB_1DF06B603132.P001/REF.pdf
https://pergamos.lib.uoa.gr/uoa/dl/object/3483258
https://hal.science/hal-04654374v1
https://doi.org/10.1097/qad.0000000000003924
https://hal.science/hal-04654374v1/document
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0 (http://creativecommons.org/licenses/by/4.0/)
Přístupové číslo: edsair.doi.dedup.....57c112593479d58e2dd37642589a0989
Databáze: OpenAIRE
Popis
Abstrakt:Objective: Interruptions in care of people with HIV (PWH) on antiretroviral therapy (ART) are associated with adverse outcomes, but most studies have relied on composite outcomes. We investigated whether mortality risk following care interruptions differed from mortality risk after first starting ART. Design: Collaboration of 18 European and North American HIV observational cohort studies of adults with HIV starting ART between 2004 and 2019. Methods: Care interruptions were defined as gaps in contact of ≥365 days, with a subsequent return to care (distinct from loss to follow-up), or ≥270 days and ≥545 days in sensitivity analyses. Follow-up time was allocated to no/preinterruption or postinterruption follow-up groups. We used Cox regression to compare hazards of mortality between care interruption groups, adjusting for time-updated demographic and clinical characteristics and biomarkers upon ART initiation or re-initiation of care. Results: Of 89 197 PWH, 83.4% were male and median age at ART start was 39 years [interquartile range (IQR): 31–48)]. 8654 PWH (9.7%) had ≥1 care interruption; 10 913 episodes of follow-up following a care interruption were included. There were 6104 deaths in 536 334 person-years, a crude mortality rate of 11.4 [95% confidence interval (CI): 11.1–11.7] per 1000 person-years. The adjusted mortality hazard ratio (HR) for the postinterruption group was 1.72 (95% CI: 1.57–1.88) compared with the no/preinterruption group. Results were robust to sensitivity analyses assuming ≥270-day (HR 1.49, 95% CI: 1.40–1.60) and ≥545-day (HR 1.67, 95% CI: 1.48–1.88) interruptions. Conclusions: Mortality was higher among PWH reinitiating care following an interruption, compared with when PWH initially start ART, indicating the importance of uninterrupted care.
ISSN:14735571
02699370
DOI:10.1097/qad.0000000000003924