Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy
To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Col...
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| Vydáno v: | PloS one Ročník 11; číslo 8; s. e0160460 |
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| Hlavní autoři: | , , , , , , , , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
Public Library of Science
15.08.2016
Public Library of Science (PLoS) |
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| ISSN: | 1932-6203, 1932-6203 |
| On-line přístup: | Získat plný text |
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| Abstract | To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years.
We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA.
During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years.
Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. |
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| AbstractList | To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years.OBJECTIVESTo estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years.We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA.METHODSWe used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA.During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years.RESULTSDuring 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years.Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes.CONCLUSIONSViral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. ObjectivesTo estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years.MethodsWe used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA.ResultsDuring 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years.ConclusionsViral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and survived for more than ten years. Methods We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. Results During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Conclusions Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for more than ten years. We used data from 18 European and North American HIV cohort studies contributing to the Antiretroviral Therapy Cohort Collaboration. We followed up patients from ten years after start of combination antiretroviral therapy. We estimated overall and cause-specific mortality rate ratios for age, sex, transmission through injection drug use, AIDS, CD4 count and HIV-1 RNA. During 50,593 person years 656/13,011 (5%) patients died. Older age, male sex, injecting drug use transmission, AIDS, and low CD4 count and detectable viral replication ten years after starting combination antiretroviral therapy were associated with higher subsequent mortality. CD4 count at ART start did not predict mortality in models adjusted for patient characteristics ten years after start of antiretroviral therapy. The most frequent causes of death (among 340 classified) were non-AIDS cancer, AIDS, cardiovascular, and liver-related disease. Older age was strongly associated with cardiovascular mortality, injecting drug use transmission with non-AIDS infection and liver-related mortality, and low CD4 and detectable viral replication ten years after starting antiretroviral therapy with AIDS mortality. Five-year mortality risk was <5% in 60% of all patients, and in 30% of those aged over 60 years. Viral replication, lower CD4 count, prior AIDS, and transmission via injecting drug use continue to predict higher all-cause and AIDS-related mortality in patients treated with combination antiretroviral therapy for over a decade. Deaths from AIDS and non-AIDS infection are less frequent than deaths from other non-AIDS causes. |
| Audience | Academic |
| Author | Trickey, Adam Boesecke, Christoph Saag, Michael Justice, Amy C. Sterne, Jonathan A. C. Cazanave, Charles Hernando, Vicky Shepherd, Leah Crane, Heidi Smit, Colette d’Arminio Monforte, Antonella May, Margaret T. Vehreschild, Janne Grabar, Sophie Lampe, Fiona Montero, Marta Zangerle, Robert Miro, Jose Obel, Niels Sterling, Timothy Cavassini, Matthias Gill, Michael John Samji, Hasina Ingle, Suzanne |
| AuthorAffiliation | 20 Innsbruck Medical University, Innsbruck, Austria 10 INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France 21 Yale University School of Medicine, New Haven, CT, United States of America, and VA Connecticut Healthcare System, West Haven, CT, United States of America 13 Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland 14 Research Department of Infection and Population Health, UCL Medical School, London, United Kingdom 4 Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark 7 Department of Internal Medicine, University of Bonn, Bonn, Germany 12 Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, F-33000, France 6 Center for AIDS Research, University of Washington, Seattle, WA, United States of America University Hospital Zurich, SWITZERLAND 23 Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain 5 Division of Infectious |
| AuthorAffiliation_xml | – name: 19 La Fe Hospital, Valencia, Spain – name: 14 Research Department of Infection and Population Health, UCL Medical School, London, United Kingdom – name: 11 Université Paris Descartes et Assistance Publique-Hôpitaux de Paris, Groupe hospitalier Cochin Hôtel-Dieu, Paris, France – name: 7 Department of Internal Medicine, University of Bonn, Bonn, Germany – name: 12 Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, F-33000, France – name: 17 Division of Infectious Disease, Department of Medicine, University of Alabama, Birmingham, United States of America – name: 8 Epidemiology and Population Health Program, British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, and Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada – name: 10 INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France – name: 1 School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom – name: 16 Stichting HIV Monitoring, Amsterdam, the Netherlands – name: 5 Division of Infectious Diseases, University of Calgary, Calgary, Canada – name: 6 Center for AIDS Research, University of Washington, Seattle, WA, United States of America – name: 23 Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain – name: 22 Vanderbilt University School of Medicine, Nashville, TN, United States of America – name: 4 Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark – name: 2 German Centre for Infection Research, partner site Bonn-Cologne, Cologne, Germany – name: 20 Innsbruck Medical University, Innsbruck, Austria – name: 3 Department I for Internal Medicine, University Hospital of Cologne, Cologne, Germany – name: 18 Red de Investigación en Sida, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Avda. Monforte de Lemos, 5 28029, Madrid, Spain – name: University Hospital Zurich, SWITZERLAND – name: 9 Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France – name: 13 Service of Infectious Diseases, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland – name: 15 Clinic of Infectious Diseases & Tropical Medicine, San Paolo Hospital, University of Milan, Milan, Italy – name: 21 Yale University School of Medicine, New Haven, CT, United States of America, and VA Connecticut Healthcare System, West Haven, CT, United States of America |
| Author_xml | – sequence: 1 givenname: Adam orcidid: 0000-0003-3462-2898 surname: Trickey fullname: Trickey, Adam – sequence: 2 givenname: Margaret T. surname: May fullname: May, Margaret T. – sequence: 3 givenname: Janne surname: Vehreschild fullname: Vehreschild, Janne – sequence: 4 givenname: Niels surname: Obel fullname: Obel, Niels – sequence: 5 givenname: Michael John surname: Gill fullname: Gill, Michael John – sequence: 6 givenname: Heidi surname: Crane fullname: Crane, Heidi – sequence: 7 givenname: Christoph surname: Boesecke fullname: Boesecke, Christoph – sequence: 8 givenname: Hasina surname: Samji fullname: Samji, Hasina – sequence: 9 givenname: Sophie surname: Grabar fullname: Grabar, Sophie – sequence: 10 givenname: Charles surname: Cazanave fullname: Cazanave, Charles – sequence: 11 givenname: Matthias surname: Cavassini fullname: Cavassini, Matthias – sequence: 12 givenname: Leah surname: Shepherd fullname: Shepherd, Leah – sequence: 13 givenname: Antonella surname: d’Arminio Monforte fullname: d’Arminio Monforte, Antonella – sequence: 14 givenname: Colette surname: Smit fullname: Smit, Colette – sequence: 15 givenname: Michael surname: Saag fullname: Saag, Michael – sequence: 16 givenname: Fiona surname: Lampe fullname: Lampe, Fiona – sequence: 17 givenname: Vicky surname: Hernando fullname: Hernando, Vicky – sequence: 18 givenname: Marta surname: Montero fullname: Montero, Marta – sequence: 19 givenname: Robert surname: Zangerle fullname: Zangerle, Robert – sequence: 20 givenname: Amy C. surname: Justice fullname: Justice, Amy C. – sequence: 21 givenname: Timothy surname: Sterling fullname: Sterling, Timothy – sequence: 22 givenname: Jose surname: Miro fullname: Miro, Jose – sequence: 23 givenname: Suzanne surname: Ingle fullname: Ingle, Suzanne – sequence: 24 givenname: Jonathan A. C. surname: Sterne fullname: Sterne, Jonathan A. C. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27525413$$D View this record in MEDLINE/PubMed https://hal.sorbonne-universite.fr/hal-01358230$$DView record in HAL |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2016 Public Library of Science 2016 Trickey 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. Attribution 2016 Trickey et al 2016 Trickey et al |
| Copyright_xml | – notice: COPYRIGHT 2016 Public Library of Science – notice: 2016 Trickey 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. – notice: Attribution – notice: 2016 Trickey et al 2016 Trickey et al |
| CorporateAuthor | Antiretroviral Therapy Cohort Collaboration (ART-CC) |
| CorporateAuthor_xml | – name: Antiretroviral Therapy Cohort Collaboration (ART-CC) |
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| DOI | 10.1371/journal.pone.0160460 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Membership of the ART-CC steering group and coordinating committee is provided in the Acknowledgments. Competing Interests: Abbott, Gilead, Tibotec-Upjohn, ViiV Healthcare, MSD, GlaxoSmithKline, Pfizer, Bristol Myers Squibb, Roche and Boehringer-Ingelheim are commercial organisations that have funded cohorts that provide data to the ART-CC. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. Conceived and designed the experiments: JS MM.Analyzed the data: AT.Contributed reagents/materials/analysis tools: JV NO MJG HC CB HS SG CC MC LS AD CS MS FL VH MM RZ AJ TS JM.Wrote the paper: AT MM JV NO MJG HC CB HS SG CC MC LS AD CS MS FL VH MM RZ AJ TS JM SI JS. |
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| Snippet | To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and survived for... Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and... Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and... ObjectivesTo estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and... ObjectivesTo estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996-1999 and... Objectives To estimate mortality rates and prognostic factors in HIV-positive patients who started combination antiretroviral therapy between 1996–1999 and... |
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| SubjectTerms | Acquired immune deficiency syndrome Adolescent Adult Age Aged AIDS Anti-HIV Agents - pharmacology Anti-HIV Agents - therapeutic use Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Biology and Life Sciences Cancer Cardiovascular diseases Care and treatment CD4 antigen Cohort analysis Demography Drug abuse Ecology, environment Fatalities Female Health risks HIV HIV Infections - drug therapy HIV Infections - mortality HIV patients HIV-1 - drug effects HIV-1 - physiology Human immunodeficiency virus Human immunodeficiency virus 1 Humans Infections Lentivirus Life Sciences Liver Liver cancer Liver diseases Male Medical prognosis Medicine and Health Sciences Middle Aged Mortality Mortality risk Patient outcomes Patients People and Places Replication Ribonucleic acid Risk Factors RNA Sex Sexually transmitted diseases STD Survival Survival Analysis Therapy Young Adult |
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| Title | Cause-Specific Mortality in HIV-Positive Patients Who Survived Ten Years after Starting Antiretroviral Therapy |
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| Volume | 11 |
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