• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Shifting causes of death in HIV patients from 1999-2011 [D:A:D study]

byStefan TrelaandXiaozhou Liu
July 18, 2014
in Cardiology, Chronic Disease, Gastroenterology, Infectious Disease, Public Health
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. The rate of death among HIV-positive individuals treated with antiretroviral therapy decreased from 1999-2011. The leading causes of death were due to AIDS-related causes, non-AIDS-defining cancers, liver disease, and cardiovascular disease. 

2. The percentage of all deaths due to AIDS-related causes, cardiovascular disease, and liver disease decreased from 1999-2000 to 2009-2011, while deaths due to non-AIDS-related cancers increased in the same time period. 

Evidence Rating Level: 2 (Good) 

Study Rundown: The development of antiretroviral therapy (ART) in the treatment of HIV has led to a decrease in AIDS-related mortality in the HIV-positive population, with life expectancy nearing that of the general population. However, non-AIDS related comorbidities may be higher in HIV patients due to higher levels of traditional risk factors such as smoking and hepatitis co-infection, chronic inflammation associated with HIV infection, and ART-related adverse effects such as dyslipidemia and diabetes. The Data collection on Adverse events of anti-HIV Drugs (D:A:D) study followed HIV-positive participants receiving care in Europe, USA, and Australia from 1999 to 2011 to identify trends in all-cause mortality and mortality due to specific organ systems or cancers.

Leading causes of death were AIDS-related, followed by non-AIDS-defining cancers, liver disease, and cardiovascular disease. The percentage of all deaths due to AIDS-related causes decreased from 1999-2000 to 2009-11 but remained the most common cause of death. Deaths due to cardiovascular disease and liver disease also decreased while non-AIDS-related cancer deaths increased during the same time period. Limitations of this study include the exclusion of HIV-infected individuals not treated regularly or unaware of their infection status as well as non-HIV-infected controls. The authors suggest that improvements in mortality over time can be explained by the benefit of antiretroviral therapy and changes in CD4 cell count but the relative increase in non-AIDS-related cancer deaths warrant further investigation.

This study was funded by the Oversight Committee for the Evaluation of Metabolic Complications of HAART, with representatives from academia, patient community, US Food and Drug Administration, European Medicines Agency and consortium of AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, ViiV Healthcare, Merck, Pfizer, F Hoffmann-La Roche, and Janssen Pharmaceuticals.

Click to read the study, published today in The Lancet

RELATED REPORTS

The 2 Minute Medicine Podcast Episode 6

The Scan by 2 Minute Medicine®: The Genetics of Alzheimer’s Disease, the Silent Killer, a Holiday Blizzard and an HIV Vaccine on the Horizon

Risk scores perform moderately well in discriminating people living with HIV with higher vs lower cardiovascular disease risk

Relevant Reading: Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration

In-Depth [prospective cohort]: 49,731 HIV-positive individuals receiving care at 212 clinics in Europe, USA, and Australia were included in the study and recruited at three different intervals: 1999-2001, 2003-04, and 2010. Participants were followed from entry until 6 months after their last clinic visit, 2011, or death, whichever occurred first. 3,909 deaths occurred over 308,719 person-years of follow-up (median 5.8 person-years, Interquartile range [IQR] 3.3-9.9), corresponding to a crude incidence mortality rate of 12.7 per 1000 person-years (95% Confidence Interval [CI] 12.3-13.1).

A higher proportion of deaths occurred in participants that were men, hepatitis C positive, IV drug users, smokers, previously diagnosed with AIDS, and had a lower median CD4 count at study entry than the rest of the study population. Leading causes of death were AIDS-related (1123 [29%] deaths), non-AIDS-defining cancers (590 [15%] deaths), liver disease (515 [13%] deaths), and cardiovascular disease (436 [11%] deaths). The percentage of all deaths due to AIDS (87/256 [34%] in 1999-2000 vs. 141/627 [22%] in 2009-11; p<0.0001) and liver disease (40/256 [16%] vs. 64/627 [10%]) decreased, while non-AIDS-related cancers increased (24/256 [9%] vs. 142/627 [23%]). Rates of all-cause death per 1000 person-years decreased from 17.5 in 1999-2000 to 9.1 in 2009-11, as well as AIDS-related (5.9 to 2.0), liver disease (2.7 to 0.9), and cardiovascular disease deaths (1.8 to 0.9). However, non-AIDS-related cancers increased slightly (1.6 to 2.1, p=0.58). After adjusting for factors that changed over time, including CD4 cell count, there was no decrease in AIDS-related death rates (relative rate for 2009-11 vs. 1999-2000: 0.92 [95% CI 0.70-1.22]). However, all-cause (0.72 [0.61-0.83]), liver disease (0.48 [0.32-0.74]), and cardiovascular disease (0.33 [0.20-0.53]) death rates did decrease over time.

Image: PD 

More from this author: New dengue fever vaccine effective in phase 3 trial, Insulin pumps more effective than multiple daily injections in type II diabetics [OpT2mise trial], Heart attack hospitalization rate in China quadruples from 2001-2011, Vitamin D supplementation does not reduce risk of falls, ¹⁸F-FDG PET brain imaging could predict recovery in vegetative patients

©2012-2014 2minutemedicine.com. All rights reserved. No works may be reproduced without expressed written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors, editors, staff or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT.

Tags: AIDSHIV
Previous Post

Low reoccurrence in nipple-sparing mastectomy for BRCA1/2 cancers

Next Post

Risk of delayed-onset ulnar neuritis after arthroscopic release of elbow contracture

RelatedReports

2MM Podcast

The 2 Minute Medicine Podcast Episode 6

January 13, 2023
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: The Genetics of Alzheimer’s Disease, the Silent Killer, a Holiday Blizzard and an HIV Vaccine on the Horizon

January 11, 2023
Few high school students, young adults get HIV testing
Cardiology

Risk scores perform moderately well in discriminating people living with HIV with higher vs lower cardiovascular disease risk

January 3, 2023
Positive physician experience in the Pediatric AIDS Corps
Cardiology

Risk of cardiovascular pathology determined using advanced cardiovascular imaging limited by heterogeneity amongst patients with human immunodeficiency virus

September 17, 2022
Next Post
Risk of delayed-onset ulnar neuritis after arthroscopic release of elbow contracture

Risk of delayed-onset ulnar neuritis after arthroscopic release of elbow contracture

Classics Series, Landmark Trials in Medicine

Dexamethasone effective as initial therapy for immune thrombocytopenic purpura [Classics Series]

BRAF V600E mutations linked with increased mortality in thyroid cancer

Proposed need for regulation of direct-to-consumer genetic testing

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Deep intronic FGF14 repeat expansion associated with late-onset cerebella ataxia
  • Plant-based diets may be associated with lower risk of aggressive prostate cancer
  • #VisualAbstract: Adagrasib provides antitumour activity against KRAS G12C mutant metastatic colorectal cancer both as monotherapy and in combination with cetuximab
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options