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dc.contributor.author | Pettit, April C | |
dc.contributor.author | Giganti, Mark J | |
dc.contributor.author | Ingle, Suzanne M | |
dc.contributor.author | May, Margaret T | |
dc.contributor.author | Shepherd, Bryan E | |
dc.contributor.author | Gill, Michael J | |
dc.contributor.author | Fätkenheuer, Gerd | |
dc.contributor.author | Abgrall, Sophie | |
dc.contributor.author | Saag, Michael S | |
dc.contributor.author | Amo, Julia del | |
dc.contributor.author | Justice, Amy C | |
dc.contributor.author | Miro, Jose M | |
dc.contributor.author | Cavasinni, Matthias | |
dc.contributor.author | Dabis, François | |
dc.contributor.author | Monforte, Antonella D | |
dc.contributor.author | Reiss, Peter | |
dc.contributor.author | Guest, Jodie | |
dc.contributor.author | Moore, David | |
dc.contributor.author | Shepherd, Leah | |
dc.contributor.author | Obel, Niels | |
dc.contributor.author | Crane, Heidi M | |
dc.contributor.author | Smith, Colette | |
dc.contributor.author | Teira, Ramon | |
dc.contributor.author | Zangerle, Robert | |
dc.contributor.author | Sterne, Jonathan Ac | |
dc.contributor.author | Sterling, Timothy R | |
dc.date.accessioned | 2018-02-21T12:03:28Z | |
dc.date.available | 2018-02-21T12:03:28Z | |
dc.date.issued | 2018-01 | |
dc.identifier.citation | J Int AIDS Soc. 2018; 21(1): e25031 | es_ES |
dc.identifier.uri | http://hdl.handle.net/20.500.12105/5598 | |
dc.description.abstract | INTRODUCTION: HIV-1 infection leads to chronic inflammation and to an increased risk of non-AIDS mortality. Our objective was to determine whether AIDS-defining events (ADEs) were associated with increased overall and cause-specific non-AIDS related mortality after antiretroviral therapy (ART) initiation. METHODS: We included HIV treatment-naïve adults from the Antiretroviral Therapy Cohort Collaboration (ART-CC) who initiated ART from 1996 to 2014. Causes of death were assigned using the Coding Causes of Death in HIV (CoDe) protocol. The adjusted hazard ratio (aHR) for overall and cause-specific non-AIDS mortality among those with an ADE (all ADEs, tuberculosis (TB), Pneumocystis jiroveci pneumonia (PJP), and non-Hodgkin's lymphoma (NHL)) compared to those without an ADE was estimated using a marginal structural model. RESULTS: The adjusted hazard of overall non-AIDS mortality was higher among those with any ADE compared to those without any ADE (aHR 2.21, 95% confidence interval (CI) 2.00 to 2.43). The adjusted hazard of each of the cause-specific non-AIDS related deaths were higher among those with any ADE compared to those without, except metabolic deaths (malignancy aHR 2.59 (95% CI 2.13 to 3.14), accident/suicide/overdose aHR 1.37 (95% CI 1.05 to 1.79), cardiovascular aHR 1.95 (95% CI 1.54 to 2.48), infection aHR (95% CI 1.68 to 2.81), hepatic aHR 2.09 (95% CI 1.61 to 2.72), respiratory aHR 4.28 (95% CI 2.67 to 6.88), renal aHR 5.81 (95% CI 2.69 to 12.56) and central nervous aHR 1.53 (95% CI 1.18 to 5.44)). The risk of overall and cause-specific non-AIDS mortality differed depending on the specific ADE of interest (TB, PJP, NHL). CONCLUSIONS: In this large multi-centre cohort collaboration with standardized assignment of causes of death, non-AIDS mortality was twice as high among patients with an ADE compared to without an ADE. However, non-AIDS related mortality after an ADE depended on the ADE of interest. Although there may be unmeasured confounders, these findings suggest that a common pathway may be independently driving both ADEs and NADE mortality. While prevention of ADEs may reduce subsequent death due to NADEs following ART initiation, modification of risk factors for NADE mortality remains important after ADE survival. | es_ES |
dc.description.sponsorship | We would like to thank the following cohorts for participating in this study; the AIDS Therapy Evaluation Project Netherlands (ATHENA); ANRS CO4 French Hospital Database on HIV (FHDH); ANRS CO3 Aquitaine Cohort, France; Departments of Internal Medicine at University of Cologne and Bonn, Germany; K€oln/Bonn Cohort, Germany; Italian Cohort of Antiretroviral-Na€ıve Patients (ICONA); CORIS, Spain; Proyecto para la Informatizaci on del Seguimiento Cl ınico-epidemiol ogico de la Infecci on por HIV y SIDA (PISCIS), Spain; Royal Free Hospital Cohort, London UK; Swiss HIV Cohort Study (SHCS); The Multicenter Study Group on EuroSIDA; Southern Alberta Clinic, Canada; HIV Atlanta Veterans affairs Cohort Study (HAVACS), USA; UAB 1917 Clinic Cohort, Birmingham, Alabama, USA; Veterans Ageing Cohort Study (VACS8),USA; Vanderbilt- Meharry and Tennessee Center for AIDS Research, Nashville, Tennessee, USA; University of Washington Harborview Medical Center, USA; € Osterreichische HIV-Kohortenstudie (OEHIVKOS), Austria; Danish HIV Cohort Study, Denmark; VACH, (Spain); and HAART Observational Medical Evaluation and Research (HOMER), British Columbia, Canada. We would also like to thank the ART-CC Steering group. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Wiley | es_ES |
dc.type.hasVersion | VoR | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | AIDS-defining events | es_ES |
dc.subject | Pneumocystis jiroveci pneumonia | es_ES |
dc.subject | Marginal structural model | es_ES |
dc.subject | Non-AIDS mortality | es_ES |
dc.subject | Non-Hodgkin's lymphoma | es_ES |
dc.subject | Tuberculosis | es_ES |
dc.title | Increased non-AIDS mortality among persons with AIDS-defining events after antiretroviral therapy initiation | es_ES |
dc.type | journal article | es_ES |
dc.rights.license | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.identifier.pubmedID | 29334197 | es_ES |
dc.format.volume | 21 | es_ES |
dc.format.number | 1 | es_ES |
dc.format.page | e25031 | es_ES |
dc.identifier.doi | 10.1002/jia2.25031 | es_ES |
dc.contributor.funder | Medical Research Council (Reino Unido) | |
dc.contributor.funder | Department for International Development (Reino Unido) | |
dc.contributor.funder | National Institutes of Health (Estados Unidos) | |
dc.contributor.funder | Vanderbilt University Medical Center (Estados Unidos) | |
dc.contributor.funder | Ministerio de Sanidad y Consumo (España) | |
dc.contributor.funder | Instituto de Salud Carlos III | |
dc.contributor.funder | Red de Investigación Cooperativa en Investigación en Sida (España) | |
dc.contributor.funder | Agence Nationale de Recherches sur le sida et les hépatites virales (Francia) | |
dc.contributor.funder | Stichting HIV Monitoring (Netherlands) | |
dc.contributor.funder | Augustinus Foundation | |
dc.description.peerreviewed | Sí | es_ES |
dc.identifier.e-issn | 1758-2652 | es_ES |
dc.identifier.journal | Journal of the International AIDS Society | es_ES |
dc.repisalud.centro | ISCIII::Centro Nacional de Epidemiología | es_ES |
dc.repisalud.institucion | ISCIII | es_ES |
dc.relation.projectID | info:eu-repo/grantAgreement/EC/FP7/260694/EU | es_ES |
dc.rights.accessRights | open access | es_ES |