Resum
Idioma original | English |
---|---|
Pàgines (de-a) | 1632-1641 |
Nombre de pàgines | 10 |
Revista | Archives of Internal Medicine |
Volum | 166 |
Número | 15 |
DOIs | |
Estat de la publicació | Publicada - 2006 |
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In: Archives of Internal Medicine, Vol. 166, Núm. 15, 2006, pàg. 1632-1641.
Producció científica: Contribució a una revista › Article › Recerca › Avaluat per experts
TY - JOUR
T1 - Liver-related deaths in persons infected with the human immunodeficiency virus: The D:A:D Study
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PY - 2006
Y1 - 2006
N2 - Background: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. Methods: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow- up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. Results: There were 1246 deaths (5.3%; 1.6 per 100 person- years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis coinfections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for 500/ μL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P=.008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P=.02). Conclusions: Liver-related death was the most frequent cause of non-AIDS-related death.Wefound a strong association between immunodeficiency and risk of liverrelated death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop. © 2006 American Medical Association. All rights reserved.
AB - Background: An increasing proportion of deaths among human immunodeficiency virus (HIV)-infected persons with access to combination antiretroviral therapy (cART) are due to complications of liver diseases. Methods: We investigated the frequency of and risk factors associated with liver-related deaths in the Data Collection on Adverse Events of Anti-HIV Drugs study, which prospectively evaluated 76 893 person-years of follow- up in 23 441 HIV-infected persons. Multivariable Poisson regression analyses identified factors associated with liver-related, AIDS-related, and other causes of death. Results: There were 1246 deaths (5.3%; 1.6 per 100 person- years); 14.5% were from liver-related causes. Of these, 16.9% had active hepatitis B virus (HBV), 66.1% had hepatitis C virus (HCV), and 7.1% had dual viral hepatitis coinfections. Predictors of liver-related deaths were latest CD4 cell count (adjusted relative rate [RR], 16.1; 95% confidence interval [CI], 8.1-31.7 for 500/ μL), age (RR, 1.3; 95% CI, 1.2-1.4 per 5 years older), intravenous drug use (RR, 2.0; 95% CI, 1.2-3.4), HCV infection (RR, 6.7; 95% CI, 4.0-11.2), and active HBV infection (RR, 3.7; 95% CI, 2.4-5.9). Univariable analyses showed no relationship between cumulative years patients were receiving cART and liver-related death (RR, 1.00; 95% CI, 0.93-1.07). Adjustment for the most recent CD4 cell count and patient characteristics resulted in an increased risk of liver-related mortality per year of mono or dual antiretroviral therapy before cART (RR, 1.09; 95% CI, 1.02-1.16; P=.008) and per year of cART (RR, 1.11; 95% CI, 1.02-1.21; P=.02). Conclusions: Liver-related death was the most frequent cause of non-AIDS-related death.Wefound a strong association between immunodeficiency and risk of liverrelated death. Longer follow-up is required to investigate whether clinically significant treatment-associated liver-related mortality will develop. © 2006 American Medical Association. All rights reserved.
KW - antiretrovirus agent
KW - acquired immune deficiency syndrome
KW - adult
KW - aged
KW - article
KW - CD4 lymphocyte count
KW - clinical feature
KW - confidence interval
KW - controlled study
KW - female
KW - hepatitis B
KW - Hepatitis B virus
KW - hepatitis C
KW - Hepatitis C virus
KW - human
KW - Human immunodeficiency virus infected patient
KW - Human immunodeficiency virus infection
KW - liver disease
KW - male
KW - mortality
KW - priority journal
KW - prospective study
KW - risk factor
KW - virus hepatitis
UR - http://www.ncbi.nlm.nih.gov/pubmed/16908797
U2 - 10.1001/archinte.166.15.1632
DO - 10.1001/archinte.166.15.1632
M3 - Article
C2 - 16908797
SN - 0003-9926
VL - 166
SP - 1632
EP - 1641
JO - Archives of Internal Medicine
JF - Archives of Internal Medicine
IS - 15
ER -