| Risk of all-cause mortality associated with nonfatal AIDS and serious non-AIDS events among adults infected with HIV. | |
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MedLine Citation:
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PMID: 20177360 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Among patients with HIV, the risk of death associated with different AIDS events has been quantified, but the risk of death associated with non-AIDS events has not been examined. We compared the risk of all-cause mortality following AIDS versus serious non-AIDS (SNA) events in the Strategies for Management of Antiretroviral Therapy (SMART) study and the Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT). DESIGN: Data from 9583 HIV-infected participants, 5472 with a CD4 cell count more than 350 cells/microl enrolled in SMART and 4111 with a CD4 cell count 300 cells/microl or more enrolled in ESPRIT, were analyzed. METHODS: Cumulative mortality 6 months after AIDS and SNA events (cardiovascular, renal, hepatic disease, and malignancies) was estimated using the Kaplan-Meier method. Cox models were used to estimate hazard ratios associated with AIDS and SNA events on the risk of death overall and by treatment group within study. RESULTS: AIDS and SNA events occurred in 286 and 435 participants with 47 (16%) and 115 (26%) subsequent deaths, respectively. Six-month cumulative mortality was 4.7% [95% confidence interval (CI) 2.8-8.0] after experiencing an AIDS event and 13.4% (95% CI 10.5-17.0) after experiencing an SNA event. The adjusted hazard ratio for all-cause mortality for those who experienced AIDS versus those who did not was 4.9 (95% CI 3.6-6.8). The corresponding hazard ratio for SNA was 11.4 (95% CI 9.0-14.5) (P < 0.001 for difference in hazard ratios). Findings were similar for both treatment groups in SMART and both treatment groups in ESPRIT. CONCLUSION: Among HIV-infected persons with higher CD4 cell counts, SNA events occur more frequently and are associated with a greater risk of death than AIDS events. Future research should be aimed at comparing strategies to reduce morbidity and mortality associated with SNA events for HIV-infected persons. |
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Authors:
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Jacqueline Neuhaus; Brian Angus; Justyna D Kowalska; Alberto La Rosa; Jim Sampson; Deborah Wentworth; Amanda Mocroft; |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: AIDS (London, England) Volume: 24 ISSN: 1473-5571 ISO Abbreviation: AIDS Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-10 Completed Date: 2011-02-03 Revised Date: 2011-07-26 |
Medline Journal Info:
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Nlm Unique ID: 8710219 Medline TA: AIDS Country: England |
Other Details:
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Languages: eng Pagination: 697-706 Citation Subset: IM; X |
Affiliation:
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University of Minnesota, Minneapolis, Minnesota, USA. jacquie@ccbr.umn.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antiretroviral Therapy, Highly Active / mortality CD4 Lymphocyte Count Cardiovascular Diseases / mortality*, virology Cause of Death Female HIV Infections / drug therapy, mortality*, virology HIV-1* Humans Kaplan-Meier Estimate Liver Failure, Acute / mortality*, virology Male Neoplasms / mortality*, virology Practice Guidelines as Topic Risk Factors Viral Load |
| Grant Support | |
ID/Acronym/Agency:
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U01 AI042170-12/AI/NIAID NIH HHS; U01 AI046362-01/AI/NIAID NIH HHS; U01 AI046957-01/AI/NIAID NIH HHS; U01 AI068641-01/AI/NIAID NIH HHS; U01AI042170/AI/NIAID NIH HHS; U01AI068641/AI/NIAID NIH HHS; U01AI46362/AI/NIAID NIH HHS; U01AI46957/AI/NIAID NIH HHS |
| Comments/Corrections | |
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