Mortality, causes of death and associated factors relate to a large HIV population-based cohort

César Garriga; Patricia García de Olalla; Josep M. Miró; Inma Ocaña; Maria Jesús Barberá; Victoria Humet; Pere Domingo; Josep M. Gatell; Esteve Ribera; Mercè Gurguí; Andrés Marco; Joan A. Caylà; Sonia Gil; Eva Masdeu; Pere Simón; Miriam Ros; Roser Clos; Pilar Gorrindo; Maria G. Mateo; María M. Gutiérrez; Vicenç Falcó; Martí Vall; Pere Armengol; Maider Aranda; Teresa Carbonell; Christian Manzardo; Felipe García; José L. Blanco; Esteban Martínez; Josep Mallolas; Marianna Vitaloni; Hernando Knobel

doi:https://doi.org/10.1371/journal.pone.0145701

Mortality, causes of death and associated factors relate to a large HIV population-based cohort

César Garriga, Patricia García de Olalla, Josep M. Miró, Inma Ocaña, Maria Jesús Barberá, Victoria Humet, Pere Domingo, Josep M. Gatell, Esteve Ribera, Mercè Gurguí, Andrés Marco, Joan A. Caylà, Sonia Gil, Eva Masdeu, Pere Simón, Miriam Ros, Roser Clos, Pilar Gorrindo, Maria G. Mateo, María M. GutiérrezVicenç Falcó, Martí Vall, Pere Armengol, Maider Aranda, Teresa Carbonell, Christian Manzardo, Felipe García, José L. Blanco, Esteban Martínez, Josep Mallolas, Marianna Vitaloni, Hernando Knobel

Department of Medicine

Research output: Contribution to journal › Article › Research › peer-review

24 Citations (Scopus)

Abstract

Introduction: Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods: We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results: 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0-16.1/1000 py], 81.3%of them had a known cause of death. Mortality rate by HIVrelated causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7-6.1/1000 py), external was lower [1.7/1000 py; (1.0-2.4/1000 py)]. Survival Results: Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5-7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3-5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4-1.7) and heterosexual female (sHR:2.8; CI:1.1-7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7-123.2) and heterosexual male (sHR:11.8; CI:2.5-56.4) versusMSM. Conclusion and Recommendation: There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.

Original language	English
Article number	e0145701
Journal	PloS one
Volume	10
Issue number	12
DOIs	https://doi.org/10.1371/journal.pone.0145701
Publication status	Published - 1 Dec 2015

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Garriga, C., García de Olalla, P., Miró, J. M., Ocaña, I., Barberá, M. J., Humet, V., Domingo, P., Gatell, J. M., Ribera, E., Gurguí, M., Marco, A., Caylà, J. A., Gil, S., Masdeu, E., Simón, P., Ros, M., Clos, R., Gorrindo, P., Mateo, M. G., ... Knobel, H. (2015). Mortality, causes of death and associated factors relate to a large HIV population-based cohort. PloS one, 10(12), Article e0145701. https://doi.org/10.1371/journal.pone.0145701

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title = "Mortality, causes of death and associated factors relate to a large HIV population-based cohort",

abstract = "Introduction: Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods: We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results: 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0-16.1/1000 py], 81.3%of them had a known cause of death. Mortality rate by HIVrelated causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7-6.1/1000 py), external was lower [1.7/1000 py; (1.0-2.4/1000 py)]. Survival Results: Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5-7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3-5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4-1.7) and heterosexual female (sHR:2.8; CI:1.1-7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7-123.2) and heterosexual male (sHR:11.8; CI:2.5-56.4) versusMSM. Conclusion and Recommendation: There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.",

author = "C{\'e}sar Garriga and {Garc{\'i}a de Olalla}, Patricia and Mir{\'o}, {Josep M.} and Inma Oca{\~n}a and Barber{\'a}, {Maria Jes{\'u}s} and Victoria Humet and Pere Domingo and Gatell, {Josep M.} and Esteve Ribera and Merc{\`e} Gurgu{\'i} and Andr{\'e}s Marco and Cayl{\`a}, {Joan A.} and Sonia Gil and Eva Masdeu and Pere Sim{\'o}n and Miriam Ros and Roser Clos and Pilar Gorrindo and Mateo, {Maria G.} and Guti{\'e}rrez, {Mar{\'i}a M.} and Vicen{\c c} Falc{\'o} and Mart{\'i} Vall and Pere Armengol and Maider Aranda and Teresa Carbonell and Christian Manzardo and Felipe Garc{\'i}a and Blanco, {Jos{\'e} L.} and Esteban Mart{\'i}nez and Josep Mallolas and Marianna Vitaloni and Hernando Knobel",

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Garriga, C, García de Olalla, P, Miró, JM, Ocaña, I, Barberá, MJ, Humet, V, Domingo, P, Gatell, JM, Ribera, E, Gurguí, M, Marco, A, Caylà, JA, Gil, S, Masdeu, E, Simón, P, Ros, M, Clos, R, Gorrindo, P, Mateo, MG, Gutiérrez, MM, Falcó, V, Vall, M, Armengol, P, Aranda, M, Carbonell, T, Manzardo, C, García, F, Blanco, JL, Martínez, E, Mallolas, J, Vitaloni, M & Knobel, H 2015, 'Mortality, causes of death and associated factors relate to a large HIV population-based cohort', PloS one, vol. 10, no. 12, e0145701. https://doi.org/10.1371/journal.pone.0145701

TY - JOUR

T1 - Mortality, causes of death and associated factors relate to a large HIV population-based cohort

AU - Garriga, César

AU - García de Olalla, Patricia

AU - Miró, Josep M.

AU - Ocaña, Inma

AU - Barberá, Maria Jesús

AU - Humet, Victoria

AU - Domingo, Pere

AU - Gatell, Josep M.

AU - Ribera, Esteve

AU - Gurguí, Mercè

AU - Marco, Andrés

AU - Caylà, Joan A.

AU - Gil, Sonia

AU - Masdeu, Eva

AU - Simón, Pere

AU - Ros, Miriam

AU - Clos, Roser

AU - Gorrindo, Pilar

AU - Mateo, Maria G.

AU - Gutiérrez, María M.

AU - Falcó, Vicenç

AU - Vall, Martí

AU - Armengol, Pere

AU - Aranda, Maider

AU - Carbonell, Teresa

AU - Manzardo, Christian

AU - García, Felipe

AU - Blanco, José L.

AU - Martínez, Esteban

AU - Mallolas, Josep

AU - Vitaloni, Marianna

AU - Knobel, Hernando

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Introduction: Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods: We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results: 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0-16.1/1000 py], 81.3%of them had a known cause of death. Mortality rate by HIVrelated causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7-6.1/1000 py), external was lower [1.7/1000 py; (1.0-2.4/1000 py)]. Survival Results: Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5-7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3-5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4-1.7) and heterosexual female (sHR:2.8; CI:1.1-7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7-123.2) and heterosexual male (sHR:11.8; CI:2.5-56.4) versusMSM. Conclusion and Recommendation: There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.

AB - Introduction: Antiretroviral therapy has led to a decrease in HIV-related mortality and to the emergence of non-AIDS defining diseases as competing causes of death. This study estimates the HIV mortality rate and their risk factors with regard to different causes in a large city from January 2001 to June 2013. Materials and Methods: We followed-up 3137 newly diagnosed HIV non-AIDS cases. Causes of death were classified as HIV-related, non-HIV-related and external. We examined the effect of risk factors on survival using mortality rates, Kaplan-Meier plots and Cox models. Finally, we estimated survival for each main cause of death groups through Fine and Gray models. Mortality Results: 182 deaths were found [14.0/1000 person-years of follow-up (py); 95% confidence interval (CI):12.0-16.1/1000 py], 81.3%of them had a known cause of death. Mortality rate by HIVrelated causes and non-HIV-related causes was the same (4.9/1000 py; CI:3.7-6.1/1000 py), external was lower [1.7/1000 py; (1.0-2.4/1000 py)]. Survival Results: Kaplan-Meier estimate showed worse survival in intravenous drug user (IDU) and heterosexuals than in men having sex with men (MSM). Factors associated with HIV-related causes of death include: IDU male (subHazard Ratio (sHR):3.2; CI:1.5-7.0) and <200 CD4 at diagnosis (sHR:2.7; CI:1.3-5.7) versus ≥500 CD4. Factors associated with non-HIV-related causes of death include: ageing (sHR:1.5; CI:1.4-1.7) and heterosexual female (sHR:2.8; CI:1.1-7.3) versus MSM. Factors associated with external causes of death were IDU male (sHR:28.7; CI:6.7-123.2) and heterosexual male (sHR:11.8; CI:2.5-56.4) versusMSM. Conclusion and Recommendation: There are important differences in survival among transmission groups. Improved treatment is especially necessary in IDUs and heterosexual males.

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U2 - https://doi.org/10.1371/journal.pone.0145701

DO - https://doi.org/10.1371/journal.pone.0145701

M3 - Article

C2 - 26716982

SN - 1932-6203

VL - 10

JO - PloS one

JF - PloS one

IS - 12

M1 - e0145701

ER -

Mortality, causes of death and associated factors relate to a large HIV population-based cohort

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