Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings

Introduction: HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART). Methods: Data from 200...

ver descrição completa

Detalhes bibliográficos
Autores: Trickey, Adam, van Sighem, Ard, Stover, John, Abgrall, Sophie, Grabar, Sophie, Bonnet, Fabrice, Berenguer, Juan, Wyen, Christoph, Casabona, Jordi, d'Arminio Monforte, Antonella, Cavassini, Matthias, Amo, Julia del, Zangerle, Robert, Gill, M John, Obel, Niels, Sterne, Jonathan A C, May, Margaret T
Tipo de documento: artigo
Data de publicação:2019
País:España
Recursos:Instituto de Salud Carlos III (ISCIII)
Repositório:Repisalud
Idioma:inglês
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/11471
Acesso em linha:http://hdl.handle.net/20.500.12105/11471
Access Level:Acceso aberto
Palavra-chave:Developed Countries
Adult
Anti-HIV Agents
Cohort Studies
Europe
Female
HIV Infections
Humans
Male
Middle Aged
Models, Statistical
Mortality
Risk Factors
id ES_7a35c016487e2e20cb42d567bc53ed9a
oai_identifier_str oai:repisalud.isciii.es:20.500.12105/11471
network_acronym_str ES
network_name_str España
repository_id_str
spelling Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settingsTrickey, Adamvan Sighem, ArdStover, JohnAbgrall, SophieGrabar, SophieBonnet, FabriceBerenguer, JuanWyen, ChristophCasabona, Jordid'Arminio Monforte, AntonellaCavassini, MatthiasAmo, Julia delZangerle, RobertGill, M JohnObel, NielsSterne, Jonathan A CMay, Margaret TDeveloped CountriesAdultAnti-HIV AgentsCohort StudiesEuropeFemaleHIV InfectionsHumansMaleMiddle AgedModels, StatisticalMortalityRisk FactorsIntroduction: HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART). Methods: Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality. Results: Analyses included 94 026 PLHIV with 585 784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000-2003 were 0.0121, reducing to 0.0078 in 2012-2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130-0.0171] reducing to 0.0049 (95% CI: 0.0039-0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000-2003, dropping to 43.6% in 2012-2015. In the ART-CC, AIDS-related mortality constitutes 45.3% (95% CI: 38.4-52.9%) of mortality in 2000-2003 and 26.7% (95% CI: 19-46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3% (95% CI: 60.3-95.2%) in 2000-2003 to 30.7% (95% CI: 25.5-63.7%) in 2012-2015. Conclusion: All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000-2003 and decline more quickly to levels currently captured for recent years.Lippincott Williams & Wilkins (LWW)Medical Research Council (Reino Unido)Department for International Development (Reino Unido)NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos)National Institute for Health Research (Reino Unido)Unión EuropeaAgence Nationale de Recherches sur le sida et les hépatites virales (Francia)Institut National de la Santé et de la Recherche Médicale (Francia)Ministero della Salute (Italia)Ministerio de Sanidad y Consumo (España)Ministerio de Ciencia e Innovación (España)Red de Investigación Cooperativa en Investigación en Sida (España)Swiss National Science FoundationUnión Europea. Comisión Europea. 7 Programa Marco20202020-11-3020192019-01-0120192019-01-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/11471reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)InglésengEuropean Commission http://dx.doi.org/10.13039/501100000780 Seventh Framework Programme 260694ES RETIC RD06open 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:20.500.12105/114712026-06-12T12:43:37Z
dc.title.none.fl_str_mv Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
title Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
spellingShingle Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
Trickey, Adam
Developed Countries
Adult
Anti-HIV Agents
Cohort Studies
Europe
Female
HIV Infections
Humans
Male
Middle Aged
Models, Statistical
Mortality
Risk Factors
title_short Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
title_full Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
title_fullStr Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
title_full_unstemmed Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
title_sort Parameter estimates for trends and patterns of excess mortality among persons on antiretroviral therapy in high-income European settings
dc.creator.none.fl_str_mv Trickey, Adam
van Sighem, Ard
Stover, John
Abgrall, Sophie
Grabar, Sophie
Bonnet, Fabrice
Berenguer, Juan
Wyen, Christoph
Casabona, Jordi
d'Arminio Monforte, Antonella
Cavassini, Matthias
Amo, Julia del
Zangerle, Robert
Gill, M John
Obel, Niels
Sterne, Jonathan A C
May, Margaret T
author Trickey, Adam
author_facet Trickey, Adam
van Sighem, Ard
Stover, John
Abgrall, Sophie
Grabar, Sophie
Bonnet, Fabrice
Berenguer, Juan
Wyen, Christoph
Casabona, Jordi
d'Arminio Monforte, Antonella
Cavassini, Matthias
Amo, Julia del
Zangerle, Robert
Gill, M John
Obel, Niels
Sterne, Jonathan A C
May, Margaret T
author_role author
author2 van Sighem, Ard
Stover, John
Abgrall, Sophie
Grabar, Sophie
Bonnet, Fabrice
Berenguer, Juan
Wyen, Christoph
Casabona, Jordi
d'Arminio Monforte, Antonella
Cavassini, Matthias
Amo, Julia del
Zangerle, Robert
Gill, M John
Obel, Niels
Sterne, Jonathan A C
May, Margaret T
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Medical Research Council (Reino Unido)
Department for International Development (Reino Unido)
NIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos)
National Institute for Health Research (Reino Unido)
Unión Europea
Agence Nationale de Recherches sur le sida et les hépatites virales (Francia)
Institut National de la Santé et de la Recherche Médicale (Francia)
Ministero della Salute (Italia)
Ministerio de Sanidad y Consumo (España)
Ministerio de Ciencia e Innovación (España)
Red de Investigación Cooperativa en Investigación en Sida (España)
Swiss National Science Foundation
Unión Europea. Comisión Europea. 7 Programa Marco
dc.subject.none.fl_str_mv Developed Countries
Adult
Anti-HIV Agents
Cohort Studies
Europe
Female
HIV Infections
Humans
Male
Middle Aged
Models, Statistical
Mortality
Risk Factors
topic Developed Countries
Adult
Anti-HIV Agents
Cohort Studies
Europe
Female
HIV Infections
Humans
Male
Middle Aged
Models, Statistical
Mortality
Risk Factors
description Introduction: HIV cohort data from high-income European countries were compared with the UNAIDS Spectrum modelling parameters for these same countries to validate mortality rates and excess mortality estimates for people living with HIV (PLHIV) on antiretroviral therapy (ART). Methods: Data from 2000 to 2015 were analysed from the Antiretroviral Therapy Cohort Collaboration (ART-CC) for Austria, Denmark, France, Italy, the Netherlands, Spain, and Switzerland. Flexible parametric models were used to compare all-cause mortality rates in the ART-CC and Spectrum. The percentage of AIDS-related deaths and excess mortality (both are the same within Spectrum) were compared, with excess mortality defined as that in excess of the general population mortality. Results: Analyses included 94 026 PLHIV with 585 784 person-years of follow-up, from which there were 5515 deaths. All-cause annual mortality rates in Spectrum for 2000-2003 were 0.0121, reducing to 0.0078 in 2012-2015, whilst the ART-CC's corresponding annual mortality rates were 0.0151 [95% confidence interval (95% CI): 0.0130-0.0171] reducing to 0.0049 (95% CI: 0.0039-0.0060). The percentage of AIDS-related deaths in Spectrum was 74.7% in 2000-2003, dropping to 43.6% in 2012-2015. In the ART-CC, AIDS-related mortality constitutes 45.3% (95% CI: 38.4-52.9%) of mortality in 2000-2003 and 26.7% (95% CI: 19-46%) between 2012 and 2015. Excess mortality in the ART-CC was broadly similar to the Spectrum estimates, dropping from 75.3% (95% CI: 60.3-95.2%) in 2000-2003 to 30.7% (95% CI: 25.5-63.7%) in 2012-2015. Conclusion: All-cause mortality assumptions for PLHIV on ART in high-income European settings should be adjusted in Spectrum to be higher in 2000-2003 and decline more quickly to levels currently captured for recent years.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-01-01
2019
2019-01-01
2020
2020-11-30
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/20.500.12105/11471
url http://hdl.handle.net/20.500.12105/11471
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv European Commission http://dx.doi.org/10.13039/501100000780 Seventh Framework Programme 260694
ES RETIC RD06
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.publisher.none.fl_str_mv Lippincott Williams & Wilkins (LWW)
publisher.none.fl_str_mv Lippincott Williams & Wilkins (LWW)
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
_version_ 1869411421037527040
score 15,812429

Registros relacionados