Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection

We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS...

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Autores: Alejos, Belén, Hernando Sebastian, Victoria, Iribarren, Jose, González-García, Juan, Hernando, Asunción, Santos, Jesús, Asensi, Víctor, Gomez-Berrocal, Ana, Amo, Julia del, Jarrin Vera, Inmaculada
Tipo de documento: artigo
Data de publicação:2016
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositório:Repisalud
Idioma:inglês
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/5274
Acesso em linha:http://hdl.handle.net/20.500.12105/5274
Access Level:Acceso aberto
Palavra-chave:Adult
Cohort Studies
Coinfection
Female
HIV Infections
Hepatitis C
Humans
Male
Middle Aged
Spain
Young Adult
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repository_id_str
spelling Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfectionAlejos, BelénHernando Sebastian, VictoriaIribarren, JoseGonzález-García, JuanHernando, AsunciónSantos, JesúsAsensi, VíctorGomez-Berrocal, AnaAmo, Julia delJarrin Vera, InmaculadaAdultCohort StudiesCoinfectionFemaleHIV InfectionsHepatitis CHumansMaleMiddle AgedSpainYoung AdultWe aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.Instituto de Salud Carlos III20172017-11-0720162016-09-0920162016-09-09research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/5274reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/52742026-06-12T12:43:37Z
dc.title.none.fl_str_mv Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
title Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
spellingShingle Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
Alejos, Belén
Adult
Cohort Studies
Coinfection
Female
HIV Infections
Hepatitis C
Humans
Male
Middle Aged
Spain
Young Adult
title_short Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
title_full Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
title_fullStr Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
title_full_unstemmed Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
title_sort Overall and cause-specific excess mortality in HIV-positive persons compared with the general population: Role of HCV coinfection
dc.creator.none.fl_str_mv Alejos, Belén
Hernando Sebastian, Victoria
Iribarren, Jose
González-García, Juan
Hernando, Asunción
Santos, Jesús
Asensi, Víctor
Gomez-Berrocal, Ana
Amo, Julia del
Jarrin Vera, Inmaculada
author Alejos, Belén
author_facet Alejos, Belén
Hernando Sebastian, Victoria
Iribarren, Jose
González-García, Juan
Hernando, Asunción
Santos, Jesús
Asensi, Víctor
Gomez-Berrocal, Ana
Amo, Julia del
Jarrin Vera, Inmaculada
author_role author
author2 Hernando Sebastian, Victoria
Iribarren, Jose
González-García, Juan
Hernando, Asunción
Santos, Jesús
Asensi, Víctor
Gomez-Berrocal, Ana
Amo, Julia del
Jarrin Vera, Inmaculada
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Adult
Cohort Studies
Coinfection
Female
HIV Infections
Hepatitis C
Humans
Male
Middle Aged
Spain
Young Adult
topic Adult
Cohort Studies
Coinfection
Female
HIV Infections
Hepatitis C
Humans
Male
Middle Aged
Spain
Young Adult
description We aimed to estimate overall and cause-specific excess mortality of HIV-positive patients compared with the general population, and to assess the effect of risk factors.We included patients aged >19 years, recruited from January 1, 2004 to May 31, 2014 in Cohort of the Spanish Network on HIV/AIDS Research. We used generalized linear models with Poisson error structure to model excess mortality rates.In 10,340 patients, 368 deaths occurred. Excess mortality was 0.82 deaths per 100 person-years for all-cause mortality, 0.11 for liver, 0.08 for non-AIDS-defining malignancies (NADMs), 0.08 for non-AIDS infections, and 0.02 for cardiovascular-related causes. Lower CD4 count and higher HIV viral load, lower education, being male, and over 50 years were predictors of overall excess mortality. Short-term (first year follow-up) overall excess hazard ratio (eHR) for subjects with AIDS at entry was 3.71 (95% confidence interval [CI] 2.66, 5.19) and 1.37 (95% CI 0.87, 2.15) for hepatitis C virus (HCV)-coinfected; medium/long-term eHR for AIDS at entry was 0.90 (95% CI 0.58, 1.39) and 3.83 (95% CI 2.37, 6.19) for HCV coinfection. Liver excess mortality was associated with low CD4 counts and HCV coinfection. Patients aged ≥50 years and HCV-coinfected showed higher NADM excess mortality, and HCV-coinfected patients showed increased non-AIDS infections excess mortality.Overall, liver, NADM, non-AIDS infections, and cardiovascular excesses of mortality associated with being HIV-positive were found, and HCV coinfection and immunodeficiency played significant roles. Differential short and medium/long-term effects of AIDS at entry and HCV coinfection were found for overall excess mortality.
publishDate 2016
dc.date.none.fl_str_mv 2016
2016-09-09
2016
2016-09-09
2017
2017-11-07
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/5274
url http://hdl.handle.net/20.500.12105/5274
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,811543

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