Document Detail


Risk of non-AIDS-related mortality may exceed risk of AIDS-related mortality among individuals enrolling into care with CD4+ counts greater than 200 cells/mm3.
MedLine Citation:
PMID:  17075385     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To quantify cause-specific mortality risk attributable to non-AIDS-related and AIDS-related causes before and after the advent of highly active antiretroviral therapy (HAART). METHODS: Competing-risk methods were used to determine the cumulative AIDS-related and non-AIDS-related risk of mortality between 1990 and the end of 2003 in the Johns Hopkins HIV Clinical Cohort, a prospective cohort study. RESULTS: Beginning in 1997 with the introduction of HAART, all-cause mortality declined and has remained stable at approximately 39 deaths per 1000 person-years. AIDS-related mortality continued to decline in this period (P = 0.008), whereas non-AIDS-related mortality increased (P < 0.001). Using competing-risk methods, the risk of dying attributable to AIDS-related causes remains significantly higher than the risk of dying attributable to non-AIDS-related causes for patients with a CD4 count <or=200 cells/mm in the HAART era. For those with a CD4 count >200 cells/mm, however, non-AIDS-related mortality was greater than AIDS-related mortality, particularly among injection drug users. Other transmission categories had similar AIDS-related and non-AIDS-related cumulative mortalities. CONCLUSIONS: HAART has reduced mortality rates among HIV-infected individuals, but further efforts to reduce mortality in this population require increased attention to conditions that have not traditionally been considered to be HIV related.
Authors:
Bryan Lau; Stephen J Gange; Richard D Moore
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  44     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-21     Completed Date:  2007-03-19     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  179-87     Citation Subset:  IM; X    
Affiliation:
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. blau1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / drug therapy*,  immunology,  mortality*
Adult
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count*
Cause of Death
Cohort Studies
Female
Humans
Male
Mortality*
Prospective Studies
Grant Support
ID/Acronym/Agency:
R01-DA11602/DA/NIDA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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